Histological Assessment of Bone Regeneration in the Maxilla with Homologous Bone Graft: A Feasible Option for Maxillary Bone Reconstruction

Abstract

Bone biomaterials have been increasingly used to reconstruct maxillary atrophic ridges. Thus, the aim of this study was to evaluate bone reconstruction in the maxilla using a homologous cortico-cancellous FFB (lyophilized) graft and verify its reliability. Eight individuals were included from 2014 to 2018. The first surgery was performed to install homologous bone blocks in the maxilla. The period of the second intervention varied between 5 months and 15 days to 11 months (≈7.93 months). The biopsies were taken from the central region of the matured graft during the surgery for implant placement. All patients presented clinical and radiographic conditions for the installation of dental implants. There was a 100% of survival rate. The histological assessment showed that the homologous block bone graft was an osteoconductive biomaterial, with connective tissue present, and newly formed bone juxtaposed on its surface. There were bone trabeculae with osteocytes and active osteoblasts with connective tissue in the mineralization process; the remodeling process can be found through the reverse lines. A limited focus of necrosis with fibrosis was detected, with small resorption and areas of inflammatory infiltrate, but without clinical significance. The homologous block bone graft can be considered a feasible option to substitute the autogenous bone graft (gold standard), with predictable clinical and favorable histological results. The patients had a shorter surgical period, low morbidity, and an unlimited amount of biomaterial available at an accessible cost.