Maxillary sinus floor augmentation using bioactive glass granules and autogenous bone with simultaneous implant placement

Abstract

This clinical study was undertaken to: 1) evaluate the use of bioactive glass Biogran combined with autogenous bone as grafting material for maxillary sinus augmentation with simultaneous implant placement using radiography and histology; and 2) document the short-term post-loading success of implants inserted in sinus cavities augmented with this material. Unilateral or bilateral sinus augmentation was performed in 12 patients with 3-5 mm of alveolar crestal bone height in the posterior maxilla prior to grafting. The sinuses were grafted with bioactive glass mixed in a 4:1 ratio with autogenous bone. Simultaneously, 2-3 threaded titanium implants were inserted into the augmented sinuses. Second stage surgery was carried out 9 to 12 months post implantation. At abutment connection, 10 core biopsy specimens were taken from different grafted sites and evaluated histologically. All 27 implants were clinically stable at second stage surgery. A mean increase in mineralized tissue height of 7.1 +/- 1.6 mm was evident when comparing the pre-surgical CT scans with those performed 9-12 months following the sinus augmentation procedure. Evaluation of the cores yielded a mean of 30.6 +/- 5.7% of bone tissue in the grafted sites. One implant failed during the prosthetic phase while the remaining 26 implants were stable 12 months post loading. This study suggests that Biogran/autogenous bone graft combination used in one-stage sinus augmentation yields sufficient quality and volume of mineralized tissue for predictable simultaneous implant placement in patients with 3-5 mm of bone height prior to grafting.

Bone defect regeneration with bioactive glass implantation in rats

“…Cordioli, et al 4 , 2001, used bioactive glass granules (Biogran) in combination with autogenous bone in surgeries for maxillary sinus elevation in patients with three to five millimeter bone height at the alveolar ridge, which showed a predictable surgical procedure with achievement of good quality and adequate bone volume. Our results histologically confirm that the bioactive glass particles showed osteoconductive and osseointegration properties, as …”

Bone Forming Potential of An-Organic Bovine Bone Graft: A Cone Beam CT study

“…A Single/1-stage surgical protocol was carried out in which the implant placement was done in conjunction with the maxillary sinus augmentation [10]. The surgical stage and the second stage prosthetic protocols were standardized for each patient.…”

Maxillary sinus floor augmentation with vegetal hydroxyapatite "versus" demineralized bovine bone: A randomized clinical study with a split-mouth design

“…[25] b o v i n e b o n e [26] β-tricalcium-phosphate, [27] freeze-dried demineralized bone [28] or bioactive glass. [14] Even though results in these average, the percentage of medullary spaces was larger in Bio-Oss than in Algipore samples (38.61% ±8.90% vs. 29.23% ±7.89%); the mean value of residual particles of biomaterial was larger in Algipore than in Bio-Oss specimens (42.86% ±18.61% vs. 22.30% ±6.40% respectively) and consequently the new bone formation percentage was larger in Bio-Oss samples (39.09% ±10.42% for Bio-Oss and 27.91 ± 12.82 for Algipore).…”

“…[10,11] Actually the most frequently used bone substitute in sinus augmentation is demineralized bovine bone (DBB), either alone or in combination with autogenous bone. [5,12,13] It must be noted that allografts and xenografts used as alternatives to autografts have a potential for disease transmission [14] while alloplasts have not risks. At this purpose, some alloplastic biomaterial are used in the clinical practice to reduce biological risks.…”