scholarly journals Radiographic and Histomorphometric Evaluation of Biomaterials Used for Lateral Sinus Augmentation: A Systematic Review on the Effect of Residual Bone Height and Vertical Graft Size on New Bone Formation and Graft Shrinkage

2021 ◽  
Vol 10 (21) ◽  
pp. 4996
Author(s):  
Paolo Pesce ◽  
Maria Menini ◽  
Luigi Canullo ◽  
Shahnawaz Khijmatgar ◽  
Laura Modenese ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bone Formation ◽  
Linear Regression Analysis ◽  
Risk Of Bias ◽  
Lateral Sinus ◽  
New Bone Formation ◽  
Sinus Augmentation ◽  
Bone Gain ◽  
Bone Height ◽  
Graft Shrinkage

The aim of the present systematic review was to investigate the effect of residual bone height (RBH) and vertical bone gain on new bone formation (NBF) and graft shrinkage after lateral sinus lifts using different biomaterials. Methods: An electronic search was conducted on three databases to identify randomized controlled trials (RCTs) published until January 2021 with at least one follow-up at 6 months and at least five patients treated, comparing biomaterials used for maxillary sinus augmentation with a lateral approach. Graft volumetric changes, RBH, vertical bone gain, implant failure, and post-operative complications were evaluated. The risk of bias was assessed using the Cochrane tool. Results: We used 4010 identified studies, of which 21 were RCTs. Overall, 412 patients and 533 sinuses were evaluated. Only three publications had an overall low risk of bias. After 6 months, xenograft (XG) showed the least volume reduction (7.30 ± 15.49%), while autogenous graft (AU) was the most reabsorbed (41.71 ± 12.63%). NBF appeared to not be directly correlated with RBH; on the contrary, the overall linear regression analysis showed that NBF significantly decreased by 1.6% for each mm of postoperative vertical graft gain. This finding suggests that the greater the augmentation, the lower the NBF. A similar tendency, with a regression coefficient even higher than the overall one, was also observed with alloplast (AP) and XG. Conclusions: The present results suggested that NBF was essentially independent of preoperative bone height. On the contrary, the smaller the volume was of the graft placed, the higher the amount of new bone formed, and the smaller the graft shrinkage was. Minimizing the augmentation volume might be beneficial to graft healing and stability especially when using AP and XG.

scholarly journals Platelet-Rich Plasma in Maxillary Sinus Augmentation: Systematic Review

Materials ◽  
2020 ◽  
Vol 13 (3) ◽  
pp. 622 ◽  
Author(s):  
Holmes Ortega-Mejia ◽  
Albert Estrugo-Devesa ◽  
Constanza Saka-Herrán ◽  
Raúl Ayuso-Montero ◽  
José López-López ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bone Formation ◽  
Randomized Clinical Trials ◽  
Lower Percentage ◽  
Platelet Concentrates ◽  
Sinus Augmentation ◽  
Beneficial Effects ◽  
Healing Period ◽  
Meta Analyses ◽  
Bone Height

Background: Sinus augmentation can be performed with or without grafting biomaterials, and to date, there is no quality evidence regarding the augmentation of the sinus floor using only platelet concentrates, which can improve the healing period and enhance bone regeneration by stimulating angiogenesis and bone formation. The main objective of this paper was to assess the effect of the sole use of platelet concentrates in sinus augmentation in terms of newly formed bone, augmented bone height, and clinical outcomes and to assess the additional beneficial effects of platelet-rich fibrin (PRF) in combination with other grafting biomaterials. Methods: A systematic review was conducted following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Pooled analyses were performed with the Review Manager software. Results: For sinus elevation only using platelet concentrates, 11 studies met the inclusion criteria and were included for qualitative synthesis. Only one study was a clinical trial, which reported improved outcomes for the allograft group compared to the titanium-PRF (T-PRF) group. A total of 12 studies where PRF was used in addition to grafting biomaterials met eligibility criteria and were included in the review. Results from meta-analyses provided no additional beneficial effects of PRF in sinus augmentation in terms of bone height and percentage of soft tissue area. There was a statistically significant lower percentage of residual bone substitute material in the PRF (+) group compared to the PRF (−) group. The percentage of newly formed bone was slightly higher in the PRF (+) group, but this was not statistically significant. Conclusion: There is no robust evidence to make firm conclusions regarding the beneficial effects of the sole use of platelet concentrates in sinus augmentation. However, studies have shown favorable outcomes regarding implant survival, bone gain, and bone height. The use of PRF with other grafting biomaterials appears to provide no additional beneficial effects in sinus lift procedures, but they may improve the healing period and bone formation. Well-conducted randomized clinical trials (RCTs) are necessary to confirm the available results to provide recommendations for the clinical practice.

scholarly journals Maxillary Sinus Augmentation Using Ceramic Alloplastic Granules or Paste: An Experimental Study in Rabbits

2021 ◽  
Vol 9 (6) ◽  
pp. 65
Author(s):  
Michael Medeiros Costa ◽  
Daniele Botticelli ◽  
Ofer Moses ◽  
Yuki Omori ◽  
Shigeo Fujiwara ◽  
...  
Keyword(s):  
Bone Formation ◽  
Maxillary Sinus ◽  
Biological Behavior ◽  
Collagen Membrane ◽  
Alloplastic Material ◽  
New Bone Formation ◽  
Sinus Augmentation ◽  
Beta Tricalcium Phosphate ◽  
Sinus Lifting ◽  
Points Of View

Background: Due to the lack of data comparing the biological behavior of two formulations, granules and paste, of alloplastic graft from microtomographic and histomorphometric points of view, the aim of the present experiment was to compare the histomorphometric and microtomographic healing of two formulations, i.e., granules (MR sites) or paste (MR-inject sites) of an alloplastic graft composed of a combination of beta-tricalcium phosphate and hydroxyapatite used for maxillary sinus lifting. Methods: A sinus lifting procedure was carried out bilaterally in 20 rabbits, and the elevated space was filled with either paste or granules of an alloplastic material. A collagen membrane was placed on the antrostomy and the animals were euthanized after 2 or 10 weeks, 10 animals each group. Microtomographic and histological analyses were performed. Results: Higher proportions of new bone formation were found at the MR, compared to the MR-inject sites both after 2 weeks (2.65 ± 2.89% vs. 0.08 ± 0.12%; p < 0.01) and 10 weeks of healing (34.20 ± 13.86 vs. 23.28 ± 10.35%; p = 0.022). Conclusions: It was concluded that new bone formation was faster in the MR sites, compared to the MR-inject. However, a longer time of healing should be allowed to make final conclusions about the efficiency in bone formation of the paste formulation of the biomaterial used in the present study.

scholarly journals Effectiveness of Platelet-Rich Fibrin as an Adjunctive Material to Bone Graft in Maxillary Sinus Augmentation: A Meta-Analysis of Randomized Controlled Trails

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Ruimin Liu ◽  
Mingdong Yan ◽  
Sulin Chen ◽  
Wenxiu Huang ◽  
Dong Wu ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Bone Formation ◽  
Bone Graft ◽  
Bone Substitute ◽  
Meta Analysis ◽  
New Bone Formation ◽  
Sinus Augmentation ◽  
Platelet Rich Fibrin ◽  
Randomized Controlled ◽  
Tissue Area

Purpose. To date, it remains unknown whether the addition of platelet-rich fibrin (PRF) to bone grafts actually improves the effectiveness of maxillary sinus augmentation. This study aimed to perform a meta-analysis to evaluate the efficacy of PRF in sinus lift.Materials and Methods. PubMed, Embase, and the Cochrane Library were searched. Randomized controlled studies were identified. The risk of bias was evaluated using the Cochrane Collaboration tool.Results. Five RCTs were included in our meta-analysis. Clinical, radiographic, and histomorphometric outcomes were considered. No implant failure or graft failure was detected in all included studies within the follow-up period. The percentage of contact length between newly formed bone substitute and bone in the PRF group was lower but lacked statistical significance (3.90%, 95% CI, -2.91% to 10.71%). The percentages of new bone formation (-1.59%, 95% CI, -5.36% to 2.18%) and soft-tissue area (-3.73%, 95% CI, -10.11% to 2.66%) were higher in the PRF group but were not significantly different. The percentage of residual bone graft was not significant in either group (4.57%, 95% CI, 0% to 9.14%).Conclusions. Within the limitations of this review, it was concluded that there were no statistical differences in survival rate, new bone formation, contact between newly formed bone and bone substitute, percentage of residual bone graft (BSV/TV), and soft-tissue area between the non-PRF and PRF groups. Current evidence supporting the necessity of adding PRF to bone graft in sinus augmentation is limited.

scholarly journals Histologic, Histomorphometric, and Clinical Analysis of the Effects of Growth Factors in a Fibrin Network Used in Maxillary Sinus Augmentation

2020 ◽  
Vol 17 (6) ◽  
pp. 1918
Author(s):  
Ihsan Caglar Cinar ◽  
Bahattin Alper Gultekin ◽  
Alper Saglanmak ◽  
Serdar Yalcin ◽  
Vakur Olgac ◽  
...  
Keyword(s):  
Growth Factors ◽  
Bone Formation ◽  
Maxillary Sinus ◽  
Clinical Analysis ◽  
Controlled Clinical Trial ◽  
New Bone Formation ◽  
Sinus Augmentation ◽  
Volume Stability ◽  
Fibrin Network ◽  
Significant Difference

This randomized controlled clinical trial evaluated the effect of mineralized plasmatic matrix (MPM), comprised of synthetic graft and platelet concentrates, on new bone formation and volume stability over time in maxillary sinus lifting (MSL). Unilateral MSL was performed in 20 patients with either beta-tricalcium phosphate (β-TCP) or MPM grafts (10 sinuses each). Six months postsurgery, specimens were obtained with a trephine bur prior to implant placement in 39 cases. Volumetric changes in sinus augmentation were analyzed between 1 week (T-I) and 6 months (T-II) postsurgery. Histomorphometric and histological analyses of biopsy samples revealed mean new bone percentages of 35.40% ± 9.09% and 26.92% ± 7.26% and residual graft particle areas of 23.13% ± 6.16% and 32.25% ± 8.48% in the MPM and β-TCP groups, respectively (p < 0.05). The mean soft-tissue areas in the MPM and β-TCP groups were 41.48% ± 8.41% and 40.83% ± 8.86%, respectively (p > 0.05). Graft reductions between baseline and 6-months postprocedure in the β-TCP and MPM groups were 17.12% ± 13.55% and 14.41% ± 12.87%, respectively, with significant graft volume reduction observed in both groups (p < 0.05) while there is no significant difference between MPM and β-TCP groups (p > 0.05). Thus, MPM, representing growth factors in a fibrin network, increases new bone formation and has acceptable volume stability in MSL procedures

Alveolar Cleft Reconstruction Using Morphogenetic Protein (rhBMP-2): A Systematic Review and Meta-Analysis

2019 ◽  
Vol 57 (5) ◽  
pp. 589-598 ◽  
Author(s):  
Francisca Uribe ◽  
Juan Pablo Alister ◽  
Carlos Zaror ◽  
Sergio Olate ◽  
Rodrigo Fariña
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Meta Analysis ◽  
Bone Volume ◽  
Risk Of Bias ◽  
Control Group ◽  
Alveolar Cleft ◽  
Morphogenetic Protein ◽  
Bone Height ◽  
Average Bone

Objective: This study aimed to review the existing evidence regarding reconstruction of the alveolar cleft using recombinant human bone morphogenetic protein-2 (rhBMP-2) in terms of bone volume and bone height. Design: Systematic review and meta-analysis. Patients—Participants: A systematic search was done. Randomized and nonrandomized clinical trials, where rhBMP-2 was used in the reconstruction of human alveolar cleft were included. Interventions: Reconstruction of alveolar cleft with rhBMP-2. Main Outcome Measures: Average bone volume formation and average bone height formation in the alveolar cleft. Mean difference was calculated and pooled by meta-analysis. Results: Of 709 identified articles, 5 studies met the inclusion criteria. The average bone volume formation was higher in the rhBMP-2 group than in the control group (61.11% vs 59.12%). The average bone height formation was higher in the control group compared to the rhBMP-2 group (75.4% vs 61.5%). The risk of bias in the selected articles was high. The meta-analysis showed that rhBMP-2 treatment may benefit bone formation compared to iliac crest graft (low certainty evidence; mean difference: −208.76; 95% confidence interval: −253.59 to −163.93; −I2 = 0%). Conclusions: The results obtained in primary articles are promising but have a high risk of bias and have low quality of evidence; therefore, it is necessary to conduct controlled clinical trials with a greater number of patients to recommend the use of rhBMP-2 in the treatment of the alveolar cleft. PROSPERO registration number: CRD42018077741.

scholarly journals Acemannan Induced Bone Regeneration in Lateral Sinus Augmentation Based on Cone Beam Computed Tomographic and Histopathological Evaluation

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Hai Anh Trinh ◽  
Van Viet Dam ◽  
Wijit Banlunara ◽  
Polkit Sangvanich ◽  
Pasutha Thunyakitpisal
Keyword(s):  
Bone Formation ◽  
Alveolar Bone ◽  
Aloe Vera ◽  
Cone Beam ◽  
Lateral Sinus ◽  
Sinus Lift ◽  
Sinus Augmentation ◽  
Posterior Maxilla

Acemannan, the major polysaccharide extracted from Aloe vera, is biomaterial that has demonstrated osteoinductive effects in vitro and in vivo. However, the effect of acemannan sponges on bone formation in open-type sinus augmentation has not evaluated. Here, we report a case study using radiographic and histological analyses to investigate the effect of acemannan on bone formation after lateral sinus lift surgery. The case was a 57-year-old female patient with an atrophic left posterior maxilla who underwent lateral sinus lift using an acemannan sponge using the two-stage procedure. In the first stage, an acemannan sponge was inserted through the bony window and placed between the antral floor and the elevated sinus membrane. Cone beam computed tomography (CBCT) images were taken immediately as baseline and 6-month postoperation for evaluation. A bone core specimen was also obtained for histological examination at the time of implant placement. The histological results revealed new bone formation, and the CBCT images demonstrated increased alveolar bone height at 6-month postoperation. Our findings suggest that an acemannan sponge could be a biomaterial for inducing bone formation in sinus lift surgery.

Histomorphometric Analysis of Sinus Augmentation Using the ICB and MBCP

2007 ◽  
Vol 330-332 ◽  
pp. 1385-1388
Author(s):  
Hyun Seon Jang ◽  
Ju Un Park ◽  
Sang Joun Yu ◽  
Moon Jin Jeong ◽  
Young Sun Kwon ◽  
...  
Keyword(s):  
Bone Formation ◽  
Soft Tissues ◽  
Statistical Significance ◽  
Tissue Bank ◽  
New Bone Formation ◽  
Sinus Augmentation ◽  
Bone Biopsies ◽  
Alternative Materials ◽  
Window Opening ◽  
Study Population

The purpose of this study is to evaluate the new bone formation of sinus augmentation with using ICB (Irradiated Cancellous Bone & Marrow; Rockey Mountain Tissue Bank, Denver, Co) and MBCP (Micro-Macroporous Biphasic Calcium Phosphate;Biomatlante, France). Study population consisted of 4 patients with maxillary posterior edentulous dentition and ridge heights were less than 5 mm. ICB (Rockey Mountain Tissue Bank, Denver, Co) and MBCP (Biomatlante, France) is mixed with 50: 50. After 6 months, the bone biopsies were done with 2mm trephine bur from lateral window opening. Mean new bone formations were 26.84 %, the residual grafts were 4.92 and soft tissues were 67.98 %. The small number of biopsies did not permit analysis of statistical significance. The variability of individual patient factors do not permit definitive conclusions. The mixtures of ICB & MBCP were superior or comparable to another various bone alternative materials in new bone formation of sinus floor elevation.

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