Short‐Term Healing of Autogenous and Allogeneic Bone Grafts After Sinus Augmentation: A Report of 2 Cases

Abstract

Sinus augmentation to facilitate the placement of cylindrical endosseous implants in the posterior maxilla has become more commonplace, and many different materials have been used for the sinus graft. The results of two sinus augmentation procedures, one grafted with demineralized freeze-dried bone (DFDB) and the other with autogenous iliac bone, are presented. Bone cores were obtained with a trephine drill from the grafted regions at the time of implant placement. Eight implants were placed into the grafted areas in each subject. The sample from the sinus grafted with autogenous bone was obtained 8 months postoperatively and the bone core from the sinus grafted with DFDB was taken 16 months postoperatively. The bone specimens were subsequently examined under light microscopy. The autogenous specimens demonstrated new bone formation with increased quantity and improved quality when compared to the specimens obtained from the sites grafted with allogeneic bone. All 8 implants placed into the autogenous grafts were clinically osseointegrated at stage 2. At 16-months postsurgery, the bone core taken from the site grafted with DFDB demonstrated poor bone quality and still contained remnants of the graft material in the region approximating the sinus membrane. Two of the 8 implants placed into the allogeneic grafts failed at stage 2. These findings suggest that autogenous sinus grafts produce bone of adequate quantity and quality for implant placement, whereas DFDB sinus grafts are not completely remodeled by the host and may produce bone of insufficient quality and quantity for predictable implant placement.

Bone regeneration in rabbit sinus lifting associated with bovine BMP

“…Following sinus lifting using autogenous bone grafts in human beings, a waiting period of six to eight months is normally required before implantation can be performed 31, 32. In cases where biomaterials are used, the waiting period is typically 12–16 months 33.…”

Recombinant Human Bone Morphogenetic Protein-2 Stimulates the Osteogenic Potential of the Schneiderian Membrane: A Histometric Analysis in Rabbits

“…2 Nevertheless, the requirement of an extended healing time to gain adequate levels of bone quality remains a drawback of this procedure. [4][5][6] Dental implants in the grafted maxillary sinus should be supported largely by the regenerated bone in the augmented area, and so the quality of regeneration in all grafted sinuses may be a major factor for successful results.…”

Fresh frozen homologous bone in oral surgery: case reports

“…Some authors have described an immunological reaction to this material if the bone graft is treated appropriately (Frost et al 1982;Burchardt 1983;Kubler et al 1993;Pinholt et al 1990;Whittaker et al 1989). For this reason homologous bone, from living or dead donors, is treated with lyophilization and demineralization processes to obtain demineralized freeze-dried bone or freeze-dried bone (Becker et al 1995;Carnes et al 1999;Isaksson and Alberius 1992;Marx 1994;Nishibori et al 1994;Wetzel et al 1995). A reduced immunological reaction has been demonstrated, in both animal and human studies, when the homologous fresh-frozen bone (FFB) is frozen at low temperatures Stevenson et al 1997).…”