Bone Graft Osseous Changes After Maxillary Sinus Floor Augmentation: A Systematic Review

Abstract

This systematic review aimed to evaluate computed tomographic scans for volumetric bone gain following lateral sinus floor augmentation of the atrophic posterior maxilla after the use of various bone-grafting materials using. The databases MEDLINE, EMBASE, CINAHL, Cochrane Central Registry of Controlled Trials (CENTRAL), and SCOPUS were used for a comprehensive search for all potentially eligible randomized controlled trials (RCTs), without language restrictions, from the beginning of each database until June 2021. The predictor variables for this review were autogenous bone (AB), allografts (AG), xenografts (XG), alloplastic bone (AP), which were assessed individually, and in combination with the inclusion of growth factors with XGs. The outcome variable was the graft volume on cone beam computed tomographic (CBCT) scans. Seven RCTs with a short-term observation period were included. Topographical analyses of all graft materials identified a volumetric reduction at 6 months post-grafting, compared to values immediately after graft placement. The volumetric reduction occurred regardless of the type of bone-grafting material. The largest volumetric gain over baseline, pre-graft values, was found with the AG+XG group. Autografts, the present gold standard bone-graft, showed a high resorption rate and inferior volumetric increase when compared to alternative grafting combinations. AG and XG also showed a significant difference with less volumetric gain than AP and their combinations. No difference was detected between AP and AG+AP. However, there was significantly less volumetric gain for AP alone compared AG+XG and XG-growth factors combinations. As a result, these findings suggest significant advantages to new bone formation using grafting materials in combination. To achieve a better understanding of topographical variables related to various grafting materials, more clinically focused RCTs, with sufficient statistical power to control for confounding factors, are needed.

Bone-Regenerative Ability of Platelet-Rich Plasma Following Sinus Augmentation with Anorganic Bovine Bone: A Systematic Review with Meta-Analysis

“…In a recent systematic review, Stumbras et al [ 59 ] identified autologous bone as the best-performing graft for inducing new bone formation after MSA. In fact, autologous bone is still considered the gold standard in bone regeneration due to its high capacity for osteoconduction, osteoinduction, and osteogenesis [ 60 ]. However, there remain concerns about patients’ discomfort and potential complications at donor sites.…”

“…However, there remain concerns about patients’ discomfort and potential complications at donor sites. Autologous bone has also shown high resorption and less volume gain [ 60 ]. Other bone-grafting materials that offer higher stability have been used, such as anorganic bovine bone.…”

Horizontal ridge augmentation with particulate cortico‐cancellous freeze‐dried bone allograft alone or combined with injectable‐platelet rich fibrin in a randomized clinical trial

“…The secondary outcome of the study was histological assessment. The presence of newly‐formed bone is of utmost importance for successful dental implants, as it enables the implant to integrate securely and anchor within the jawbone 13 . During the dental implant surgery, a 2 mm trephine drill was used to obtain a biopsy from the buccal one‐third of the crest of the alveolar ridge, following the long axis of the ridge.…”

“…The presence of newly-formed bone is of utmost importance for successful dental implants, as it enables the implant to integrate securely and anchor within the jawbone. 13 During the dental implant surgery, a 2 mm trephine drill was used to obtain a biopsy from the buccal onethird of the crest of the alveolar ridge, following the long axis of the ridge. This biopsy procedure was performed in 24 participants, with 13 in the control group and 11 in the test group, at the 6-month mark after bone augmentation.…”

Sinus Augmentation for Implant Placement Utilizing a Novel Synthetic Graft Material with Delayed Immediate Socket Grafting: A 2-Year Case Study

“…Various materials have been advocated and utilized falling into the categories of allograft, xenograft and synthetic materials. Each category has been well documented for the utilization in sinus augmentation procedures in the literature [ 1 , 2 , 3 ]. Several factors weigh in decisions when selecting a type of osseous graft material.…”