Maxillary Sinus Augmentation With a Synthetic Cell-Binding Peptide: Histological and Histomorphometrical Results in Humans

Bone substitutes should be used when sufficient amounts of autologous bone cannot be harvested from intraoral donor sites. P-15 is a highly conserved linear peptide with a 15 amino acid sequence identical to the sequence contained in the residues 766 to 780 of the alpha-chain of type I collagen. PepGen P-15 (Dentsply Friadent, Mannheim, Germany) is a combination of the mineral component of bovine bone (Osteograf/N 300) with P-15. Bio-Oss (Geistlich, Mannheim, Germany) is a deproteinized sterilized bovine bone with 75% to 80% porosity and a crystal size of approximately 10 μm in the form of cortical granules. The purpose of the present histological and histomorphometrical study was to compare maxillary sinus augmentation procedures in humans performed with PepGen P-15 with procedures associated with Bio-Oss and autologous bone. Seven patients participated in this study (3 men and 4 women; ages between 48 and 69 years, mean of 58 years) and were categorized into 3 groups. In group 1, a mixture of 50% autologous bone from an intraoral source and 50% Bio-Oss was used. In group 2, the graft materials used were 50% Bio-Oss and 50% PepGen P-15. In group 3, 50% autologous bone and 50% PepGen P-15 were used. Group 1 histomorphometry showed that the percentage of newly formed bone was 38.7% ± 3.2%, marrow spaces represented 45.6% ± 5%, and residual graft particles constituted the remaining 14.4% ± 2.1%. Group 2 histomorphometry showed that newly formed bone represented 36.7% ± 3.3%, marrow spaces represented 39.7% ± 3.4%, and residual graft particles represented 19.6% ± 2.1%. In group 3, newly formed bone represented 32.2% ± 3.2%, marrow spaces represented 38% ± 2.5%, and residual graft particles represented 28.8% ± 1.1%. Nonstatistically significant differences were found in the percentage of newly formed bone in the different groups (P = .360). Statistically significant differences were found in the percentage of residual graft materials among the different groups (group 1 vs groups 2 and 3) (P = .0001). These data demonstrate that the use of bone-replacement materials, without the addition of autologous bone, could be an alternative in sinus augmentation procedures. Such treatment would increase patient satisfaction, decrease surgical complications, and save the clinician substantial operating time.