Histologic and histomorphometric evaluation of a synthetic bone substitute for maxillary sinus grafting in humans

Many of us here in India use Biphasic Ceramics such a Ossifi or Biograft for our sinus lifts. All there is an extensive orthopedic literature on the use of these materials ,studies describing their use in oral applications has been slow in coming. This study helps increase our confidence in the use of these products. It's important to note however that one needs to wait atleast 9 to 12 months for graft maturation before one can proceed to implant placement in moderate sized sinuses . In extremely large , heavily pneumatised sinuses using a mixture of alloplast and autograft will shorten healing times.

Histologic and histomorphometric evaluation of a synthetic bone substitute for maxillary sinus grafting in humans:

Abstract

Objective

The present study investigated the efficacy of a biphasic calcium phosphate as a bone grafting material for maxillary sinus augmentation in humans.

Materials and methods

Half of the thirty patients selected for sinus augmentation were grafted with biphasic calcium phosphate, whereas the other half were grafted with autogenous bone chips harvested intraorally. After 9 months of healing, bone cores were retrieved from implant sites for histologic and histomorphometric evaluation.

Results

The areas augmented with autogenous bone chips showed newly formed bone with a pattern very similar to that of the native area. Histomorphometry demonstrated that the amount of newly formed bone in the autogenous bone group was significantly greater than in the biphasic calcium phosphate group (P < 0.05). In the biphasic calcium phosphate group, less bone formation was observed in the area further away from native bone interface than in the area closer to native bone interface (P < 0.05), whereas no significant differences were observed between both areas in the autogenous group. In both groups, the implant survival rate was 100% with a minimum 1-year follow-up.

Conclusion

The data presented in this work confirm the osteoconductive properties of biphasic calcium phosphate, as well as its use in association with maxillary sinus floor augmentation procedures with successful outcomes.