Clinical, Histologic, and Histomorphometric Evaluation of Mineralized Solvent-dehydrated Bone Allograft (Puros) in Human Maxillary Sinus Grafts

Abstract

Demineralized freeze-dried bone allografts (DFDBA) have been successfully used alone or in composite grafts for many decades. Little research has been done on the effect of retaining the mineral content of bone allografts. This study histologically and histomorphometrically evaluated a new mineralized bone allograft material placed in human atrophic maxillary sinuses. Seven partially edentulous patients requiring sinus grafts before implant placement were selected for this study Their age range was 56 to 81 years (mean 67.7 years). Test grafts consisted of a mineralized solvent-dehydrated cancellous bone allograft, and control grafts were a composite of DFDBA and deproteinized bovine bone xenograft (1:1). Bilateral cases (n = 3) received both test and control grafts on opposite sides, and unilateral cases received either a test (n = 3) or control (n = 1) graft only. At 10 months, core biopsies were taken from each graft site, and dental implants were placed into the augmented bone. All bone grafts resulted in new bone formation and all implants osseointegrated. Test grafts resorbed and were replaced by newly formed bone significantly faster and in greater quantities than were control grafts. No complications with grafts or implants were noted. Both test and control grafts achieved excellent results. The faster bone formation observed with the test graft may be due, in part, to its smaller particle size compared with the bovine portion of the control graft. Test grafts were either replaced by new bone or displayed new bone-to-particle surface contact in higher percentages than did control grafts. No differences in osseointegration or graft stability were noted 2 years after the study.

Horizontal and Vertical Reconstruction of the Severely Resorbed Maxillary Jaw Using Subantral Augmentation and a Novel Tenting Technique with Bone from the Lateral Buccal Wall

“…In this study, we used MCBA based on encouraging documented reports of new bone formation [21]. Our histological results were consistent with those of Noumbissi et al [22], Froum et al [23] and Schmitt et al [13]. Therefore, MCBA can be considered as a bone substitute material that is totally resorbed and replaced with autogenous bone, integrating well into the organism [23].…”

Usage of Bone Replacement Grafts in Periodontics and Oral Implantology and Their Current Levels of Clinical Evidence — A Systematic Assessment

“…Overall, 55 studies were categorized at level I 12–66 . Twenty‐six were level II, 67–92 nine were level III, 93–101 46 were level IV S1‐S46 (see references in http://www.joponline.org/doi/suppl/10.1902/jop.2016.150512/suppl_file/150512_supapp1.pdf and http://www.joponline.org/doi/suppl/10.1902/jop.2016.150512/suppl_file/150512_supapp2.pdf in online Journal of Periodontology ), and 53 were level V S47‐S99 (see references in http://www.joponline.org/doi/suppl/10.1902/jop.2016.150512/suppl_file/150512_supapp1.pdf and http://www.joponline.org/doi/suppl/10.1902/jop.2016.150512/suppl_file/150512_supapp3.pdf in online Journal of Periodontology ). The levels of evidence of each type of bone graft and summary of the RCTs are presented in http://www.joponline.org/doi/suppl/10.1902/jop.2016.150512 in online Journal of Periodontology .…”

“…These level I studies are summarized in http://www.joponline.org/doi/suppl/10.1902/jop.2016.150512/suppl_file/150512_suptab2.pdf in online Journal of Periodontology . There were eight studies 70,79,81‐86 and five studies 94,97‐100 that met level II and III criteria, respectively. The majority were level IV studies (21 studies) S1‐S21 (see references in http://www.joponline.org/doi/suppl/10.1902/jop.2016.150512/suppl_file/150512_supapp2.pdf in online Journal of Periodontology ).…”

Histomorphometric Analysis of Maxillary Sinus Augmentation Using an Alloplast Bone Substitute

“…Deproteinized bovine bone mineral (DBBM; Bio-Oss) is well documented as an augmentation material for sinus floor elevation. 15,17,[30][31][32][33] Using DBBM, Valentini and Abensur 17 found that newly formed bone increased from 21.1% to 27.6% at 6 to 12 months and a decrease of graft particle components from 39.2% to 27%. These data are comparable to the 27.3% residual graft proportion reported in the present study.…”

“…2,17 Ample data have been reported on new bone formation in sinus floor elevation procedures; however, very few articles have dealt with the osteoconductive values of the grafted materials. 33,42,43 Proussaefs et al 42 found that 40.17% of the DBBM particle surface was in contact with bone, whereas Tadjoedin et al 43 found that only 34% to 38% of the DBBM surface was in contact with bone. Noumbissi et al 33 reported similar values for DBBM (34.75%) and higher values using a mineralized solvent dehydrated allograft (Puros).…”