Maxillary sinus augmentation using chairside bone marrow aspirate concentrates for implant site development: a systematic review of histomorphometric studies

Abstract

Maxillary sinus pneumatization following dental tooth extractions and maxillary alveolar bone resorption frequently leaves inadequate bone levels for implant placement. The objectives of this systematic review are to evaluate the effects of bone marrow aspirate concentrates (BMACs) used in maxillary sinus augmentation for implant site development.A systematic search was conducted using PubMed, EMBASE, Web of Science, Cochrane Library, and Google Scholar for studies which histomorphometrically evaluated the efficacy of BMACs and BMAC-enriched biomaterials in sinus floor elevation. Six studies were selected, and the risk of bias was evaluated.Reported ranges of vital mineralized tissue for the BMAC groups for the selected studies were 34.63–55.15% compared to 27.30% for control groups. For vital mineralized bone, these studies reported variable statistical significance. At 3–4 months, new bone formation for BMAC groups with controls using no BMAC was 7.4–12.6% and for the control groups was 9.45–14.3%. At 6 months, new bone formation for BMAC groups was 13.5–14.12% and for control groups was 10.41–13.9%. For new bone formation, these studies reported no significant difference between test and control and between 3 and 6 months histologic evaluation.Within the limits of this systematic review, the chairside method to harvest BMAC produced similar implant survival and new bone formation compared to the laboratory FICOLL group, without the additional cost and time of laboratory cell isolation techniques. The iliac crest or tibia origins, single or double centrifugation, for BMAC do not appear to be a factor for implant survival or bone formation. Although some favorable outcomes were reported, the increase in new bone formation using chairside-harvested BMAC compared to control is not predictably more significant across studies.Clinically, new bone formation in the maxillary sinus is not always contingent on the presence of BMAC. The novelty of this method requires more future studies.

Effect of enriched bone-marrow aspirates on the dimensional stability of cortico-cancellous iliac bone grafts in alveolar ridge augmentation

“…FICOLL is stated to be an optimal approach for harvesting of mononuclear cells [ 36 ]; however, it requires good manufacturing practice laboratory techniques with additional cost and time. In addition, no differences could be detected regarding the implant survival rates between chairside AMSC harvesting and FICOLL [ 37 ].…”

Ultraviolet Light Treatment of Titanium Microfiber Scaffolds Enhances Osteoblast Recruitment and Osteoconductivity in a Vertical Bone Augmentation Model: 3D UV Photofunctionalization

“…Such rough surfaces can achieve rigid bone integration without a tissue gap or intervening soft tissue [1,2,5,12,16,[23][24][25][26][27][28][29][30][31]. However, a major challenge to successful implant therapy is overcoming unfavorable host conditions including insufficient width and height of innate bone to receive an implant [32][33][34][35][36][37][38][39][40]. To achieve this, the execution and outcome of vertical bone augmentation require significant improvement [32,[41][42][43][44][45][46][47][48][49][50][51].…”

A retrospective preliminary histomorphometric and clinical investigation on sinus augmentation using enzyme-deantigenic, collagen-preserving equine bone granules and plasma rich in growth factors

“…While type I collagen may have some pro-regenerative effect, still EDEB lacks any osteogenic or other inductive potential. To possibly enhance regeneration, EDEB as well as other bone substitutes may be mixed with biological adjuncts, including cell extracts and preparations or blood derivatives, such as adipose-derived mesenchymal stem cells (ASCs), bone marrow aspirate or concentrate (BMA/ BMC), platelet-rich plasma (PRP), leukocyte/platelet-rich fibrin (L-PRF or PRF); plasma-rich in growth factor (PRGF); autogenous fibrin (AF); magnesium-enriched hydroxyapatite (MHA); and others [23][24][25][26][27][28][29][30][31][32]. While published literature exists concerning the use of these adjuncts in combination with other xenografts in alveolar bone augmentation procedures, no evidence has been ever published concerning the use of any of them concomitantly to EDEB grafting.…”