Osseointegration in a sinus augmented with bovine porous bone mineral: histological results in an implant retrieved 4 years after insertion. A case report.

Abstract

A subject of controversy in implant dentistry is what is the most appropriate material for sinus augmentation. Little is known about the healing pattern and the osseointegration processes at the interface of implants placed in different grafting materials in man. Bovine porous bone mineral (BPBM) is a xenogenic material similar to human cancellous bone with a high biocompatibility and osteoconductivity. A 50-year-old patient presented a posterior left maxilla with an insufficient bone height for implant insertion. In January 1999, a sinus lifting procedure was performed and the left sinus was augmented with BPBM; in November 1999, three implants were inserted, and in July 2000 a fixed prosthetic restoration was positioned. In June 2003 the connecting screw of the middle implant fractured and it was decided to remove the implant using a 5 mm trephine bur. All BPBM particles were surrounded by newly formed bone. No BPBM particle was in direct contact with the implant surface, and between the implant surface and the particles there was newly-formed bone. BPBM seemed to undergo a very slow resorption; the particles constituted 36% +/- 3% of the peri-implant tissues. The bone-implant contact percentage was 72% +/- 4%. In our specimens, we found an intimate, direct contact between bone and implant without an interposition of the graft material particles. A very high bone-to-implant contact percentage was present. Our results show that the slow resorption of the graft particles did not jeopardize the osseointegration of the implant.