Retrospective analysis of three different xenografts in maxillary sinus augmentation: histologic and three-dimensional radiologic study.

Abstract

Low bone density and lack of adequate vertical bone dimension as a result of maxillary sinus pneumatization present some of the most problematic cases for endosseous implant applications in posterior maxillary regions that hinder prosthetic rehabilitation; Objectives: The overall objectives of the study were to assess the histologic, histomorphometric and radiological evaluation of biopsies gathered from maxillary sinuses which were grafted with three different bovine bone particles (Bio-Oss®, Cerabone® and Ti-Oss®) and analyze the volume of the bone graft and the quantity of new bone formation; Methods and materials: Thirty-six patients with <4mm of residual ridge height unilaterally in the posterior maxilla, were equally divided into 3 groups, each of which received different bovine bone particles for maxillary sinus augmentation. Six-months later, biopsies were harvested for histological and histomorphometric evaluations. Volumetric changes in maxillary sinus augmentation were analyzed at 1-week (T-I) and 6-months (T-II) time points following maxillary sinus augmentation surgery; Results: Histomorphometric and histological analysis revealed significant difference between Ti-Oss® group compared with Bio-Oss® and Cerabone® groups (P=0.011). In term of residual graft particles and soft tissue, there were no significant differences between groups. 3-D volumetric reductions between 1-week (baseline) and 6-month time points recorded significant graft volume reduction in all groups (P<0.05). Significantly greater bone resorption and lower new-bone formation were manifested in Ti-Oss® group in comparison to the other groups; Conclusions: Within the limits of this study, histological and radiological results indicated that, Bio-Oss® and Cerabone® could be used efficiently in sinus augmentation procedures, while further prospective studies are needed to evaluate the Ti-Oss® material in maxillary sinus augmentation.