The aim of the present investigation was to test the effect of a bioresorbable membrane supported by xenografts or autografts in regenerating bone into peri-implant defects. In 3 dogs, the mandibular premolars P2, P3, P4 and M1 were extracted bilaterally. After 4 months of healing, 3 standardized bone defects were prepared on each side of the mandible and 1 implant per defect was placed. The 6 sites in each dog were distributed into 4 different treatment groups: 2 sites received a Bio-Gide membrane alone (BG); 2 sites received a Bio-Gide membrane supported by Bio-Oss (BG + BO); 1 site received the Bio-Gide membrane supported by autogenic bone harvested from the prepared defects (BG + Aut); 1 site received neither membrane nor bone graft and served as control (C). The soft tissue flaps were adapted and sutured for primary healing. No adverse events occurred during the experimental period. After 16 weeks, the dogs were sacrificed and histomorphometric examinations on non-decalcified ground sections were carried out. The vertical bone growth amounted to 45% (SD +/- 13%) of the defect height in the BG group, to 78% (SD +/- 29%) in the BG + BO group, to 69% (SD +/- 9%) in the BG + Aut group, and to 22% (SD +/- 10%) in C group. The horizontal bone growth measured 78% (SD +/- 16%) in the BG group, 81% (SD +/- 21%) in the BG + BO group, 82% (SD +/- 12%) in the BG + Aut group, and 46% (SD +/- 21%) in the C group. The vertical height of bone growth in contact with the implant measured 17% (SD +/- 12%) in the BG group, 20% (SD +/- 12%) in the BG + BO group, 17% (SD +/- 7%) in the BG + Aut group, and 12% (SD +/- 8%) in the C group. The surface fraction of the graft in direct bone contact measured 89% (SD +/- 9%) in the BG + BO group and 93% (SD +/- 3%) in the BG + Aut group. It is concluded that the bioresorbable membrane tested enhances bone regeneration, in particular in conjunction with the use of a supporting graft material. In addition, deproteinized bovine bone mineral and autogenic bone grafts appeared to be equally well integrated into regenerating bone. Finally, no additional effects in the bone growth was observed with the autogenous bone in comparison with the hydroxyapatite.

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Deproteinized cancellous bovine bone (Bio-Oss) was placed as a grafting material for sinus floor elevation in the right posterior maxilla. After 6 months of healing, 3 cylindrical titanium-plasma coated implants were inserted. Six months later at the abutment connection, it was realized that 1 of the implants could not be reconstructed due to unfavorable positioning. This implant was removed along with a small portion of the surrounding peri-implant tissues. The specimen was processed according to standard techniques for hard tissue histology. In both the grafted area and the previously existing area of the sinus floor the bone was primarily of lamellar structure. Intimate contact between newly formed bone and the particles of the graft was present. No overt signs of resorption of the graft particles were visible. Histomorphometric analysis revealed 63% of implant-bone contact in the zone of pre-existing bone, and 73% in the grafted zone. The area density of bone amounted to 27% in the non-grafted as compared to 28% in the grafted area. In conclusion, this case report documented that deproteinized bovine bone, when used as a grafting material for augmentation of the sinus floor, may lead to proper osseointegration of a dental implant.

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IntroductionAccording to the literature, it is well known that the occurrence of postoperative sinusitis, in conjunction with maxillary sinus graft, appears to be limited to patients with a predisposition for this. In order to prevent post-and also intraoperative complications, it is essential to be able to be precise in anatomical particularities and to diagnose the health status of maxillary sinus prior the grafting procedure. A team approach gathering the implant surgeon and the ENT specialist to identify those parameters is crucial for the patient selection and the prevention of complications. The aim of this short communication was to discuss a proposal for avoidance in postoperative complications in maxillary sinus grafting. Short communicationPrevention of complications is essential for the success of the procedure. A strict protocol must be implemented for patient selection in order to prevent complications. ConclusionThe team approach gathering the implant surgeon and the ENT specialist is essential for outcome of the procedure.