Maxillary Sinus Floor Augmentation Using an Equine-Derived Graft Material: Preliminary Results in 17 Patients

Abstract

Objective Sinus floor elevation with lateral approach is probably the most frequently performed reconstructive procedure to rehabilitate posterior maxilla when a bone deficiency is present. Different graft materials have been proposed and tested, often with high clinical performances and predictable results. Histological analysis is required when evaluating new materials. We investigated human biopsies retrieved after sinus floor elevation procedure by histomorphometric evaluation to test the performance of an equine-derived bone grafting material. Study Design Seventeen consecutive patients were enrolled and sinus lift surgeries were performed using an equine bone graft. Six months after surgery, at implant placement, bone samples were collected. Histomorphometry analysis was carried out on decalcified samples. Results All surgeries were uneventful and no additional grafting was required prior to implant insertion. Forty percent of new bone formation was detected, which represented the most abundant tissue retrieved, followed by the residual graft material (33%) and fibrous tissue (27%). A significant reduction in particles size demonstrates a remodeling activity of the graft material. Conclusion Within the limitations of this study, this equine-derived bone graft proved to be an effective material to induce new bone formation in the sinus floor elevation procedure.

Histological and Histomorphometric Evaluation of New Bone Formation after Maxillary Sinus Augmentation with Two Different Osteoconductive Materials: A Randomized, Parallel, Double-Blind Clinical Trial

“…The histomorphometric analyses revealed a mean formation of the new bone of 23.5% [27]. Rivara et al [30] reported, in their preliminary histomorphological study, promising results at six-months follow-up, with the significant formation of new bone tissue (39.84% ± 2.96). Stievano et al [42] performed a retrospective survival study of dental implants positioned in regenerated bone after maxillary sinus augmentation with the Biogen mix, without histological or histomorphometric analysis.…”

“…Sinus floor augmentation through a bone substitute is less invasive than autogenous bone and shows comparable results in terms of implant survival rates [11,21]. Today, a multitude of bone substitute materials with demonstrated acceptable outcomes in terms of biocompatibility and long-term stability are available from several specialized companies [22,23], and several investigations on anorganic bovine bone (ABB) [15,[24][25][26] and deproteinized equine bone mineral (DEBM) have been conducted [27][28][29][30].…”

Bone grafting materials in dentoalveolar reconstruction: A comprehensive review

“…Equine-derived bone substitutes have been described as having the ability to induce osteoblastic differentiation and angiogenesis while being absorbed by osteoclasts. In addition, the presence of neoplastic bone associated with remodeling effects was observed around the graft material 6 months postoperatively, while being described in cases of successful sinus lift [47], [48].…”

PRF-Solution in Large Sinus Membrane Perforation with Simultaneous Implant Placement-Micro CT and Histological Analysis

“…Modern implant dentistry is tightly connected to bone augmentation procedures, especially when implant insertion follows a prosthetic planning concept. Among numerous bone grafting techniques, one of the most frequently used procedures is maxillary sinus floor augmentation [1]. Surgical techniques vary in the way the sinus cavity is accessed (lateral or crestal approach) and the type of grafting material placed into the cavity [2].…”