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

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.

Preliminary Study with the Use of a Titanium Mesh as Space Maker and Implant Primary Stabilization for One-Stage Sinus Lift in Cases with Less Than 1.5 mm Residual Bone

“…Several treatment options have been utilized to overcome the issue of inadequate bone volume in the lateral area of the maxilla [ 17 ]. The subantral residual alveolar bone plays a significant role with respect to the most convenient option of surgical procedure and the timing of implant placement.…”

Long-Term Clinical Study of Implants Placed in Maxillary Sinus Floor Augmentation Using Beta-Tricalcium Phosphate

“…Scientific evidence showed that MSFA predictably leads to high implant survival rates, limited peri-implant marginal bone loss, and resulted in few overall surgical and prosthetic complications in maxillary patients [ 3 , 4 , 5 , 6 , 7 , 8 ]. The lateral osteotomy technique to approach the MFSA for increasing bone volume in the posterior maxilla is a well-established and documented surgical procedure allowing for implant placement [ 3 , 13 , 14 , 31 ]. Irrespective of the grafting materials applied (i.e., autogenous bone, allografts, xenografts, alloplastic), MFSA is accompanied by increased implant stabilization and new bone formation [ 13 , 14 , 15 ].…”

“…The lateral osteotomy technique to approach the MFSA for increasing bone volume in the posterior maxilla is a well-established and documented surgical procedure allowing for implant placement [ 3 , 13 , 14 , 31 ]. Irrespective of the grafting materials applied (i.e., autogenous bone, allografts, xenografts, alloplastic), MFSA is accompanied by increased implant stabilization and new bone formation [ 13 , 14 , 15 ].…”

“…Maxillary sinus elevation by lateral approach and a bone graft is the preferred treatment when the available bone is <4–6 mm. Additionally, when bone height varies between 3 and 5 mm, simultaneous placement of the implants is an optional alternative [ 12 , 13 ]. In MSFA using the lateral window technique, the space created between the maxillary residual ridge and elevated membrane of Schneider is filled with grafting material.…”

“…In MSFA using the lateral window technique, the space created between the maxillary residual ridge and elevated membrane of Schneider is filled with grafting material. MSFA could be implemented as either a pre-implant surgical procedure or be combined with simultaneous implant insertion when the implant can be placed with sufficient primary stability [ 12 , 13 ].…”