The Use of Cortical Heterologous Sheets for Sinus Lift Bone Grafting: A Modification of Tulasne's Technique with 7-Year Follow-up

Abstract

In this article, the authors describe their experience with using cortical deantigenated equine bone sheets in sinus lift grafting procedures performed on 23 patients. The technique employed resembles that described by Tulasne but avoids the need for using harvested calvaria bone and introduces some additional operating variants. The use of heterologous cortical bone sheets effectively managed even large lacerations of the Schneiderian membrane and allowed for immediate stabilization of the heterologous bone granules. Average histomorphometric values for bone cores collected six months after grafting, at the time of implant placement, were: newly formed bone tissue 43.9±4.2%, residual bone substitute 7.4±1.4%, medullary spaces 48.7±4.0%. At seven year follow-up, clinical and radiographic examination indicated that the use of the bone sheets preserved the regenerated bone volume. In conclusion, the use of heterologous cortical bone sheets in association with granular bone graft material enabled long-term stabilization of the graft material and effective management of intra-surgical complications.

A Preshaped Titanium Mesh for Guided Bone Regeneration with an Equine-Derived Bone Graft in a Posterior Mandibular Bone Defect: A Case Report

“…This seems to confer to the graft remodeling kinetics comparable to that of natural bone; indeed, very few residual biomaterial particles could be identified by histological examination, implying that this equine-derived xenograft can be expected to be nearly completed resorbed 6.5 years after grafting. This result is consistent with the present clinical evidence on this bone substitute [41,42,43,44,45,46,47,48,49,50].…”

Guided Bone Regeneration of an Atrophic Mandible with a Heterologous Bone Block

“…Moreover, when sites augmented with equine bone alone are compared with others augmented with the same material added to autoge-nous bone, immunohistochemical tests shows no differences between the two regarding the expression of some biochemical markers of bone regeneration. 39 Enzyme-deantigenic equine bone is used in clinical practice as a scaffold in bone regeneration of different bone defects [40][41][42] and is applied in orthopedic regenerative surgery. 43 It has been also recently used to treat cases in which implant thread exposure resulted from positioning 44 and in cases of peri-implantitis resulting in significant bone loss.…”

A comparison between anorganic bone and collagen-preserving bone xenografts for alveolar ridge preservation: systematic review and future perspectives

“…The preservation of type I collagen in bone substitutes can improve socket healing in ARP procedures by a series of processes, including (1) enhanced stimulation by endogenous growth factors; (2) longer duration of regenerative stimuli; (3) physiological modulation of bone metabolism and remodeling; and (4) increased osteoblast adhesion, proliferation, and differentiation [95][96][97][98]. Indeed, this might have contributed to the successful clinical outcomes with CBXs use reported for different oral surgery procedures including sinus lift bone grafting [42,[99][100][101][102], ridge augmentation [103][104][105], and peri-implant-guided bone regeneration [106][107][108]. However, direct clinical comparisons between anorganic and CBXs for socket preservation were only reported in three clinical trials [31,38,82], so the superiority of one biomaterial over another has not been established yet.…”