Do osteoconductive bone substitutes result in similar bone regeneration for maxillary sinus augmentation when compared to osteogenic and osteoinductive bone grafts? A systematic review and frequentist network meta-analysis (original) (raw)
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2020
Review question / Objective: What xenograft material produces greater new b o n e f o r m a t i o n i n m a x i l l a r y s i n u s augmentation? Rationale: Tow-stage sinus floor elevation u s i n g a l a t e r a l w i n d o w t e c h n i q u e represents the most widely technique to p e r f o r m b o n e a u g m e n t a t i o n i n t h e maxillary posterior region. Because intraoral donor sites provide a limited quantity of bone and the extra-oral site is not well accepted by the patients, various types of bone-substitute materials have been s u g g e s t e d f o r m a x i l l a r y p o s t e r i o r augmentation procedure. Previews studies INPLASY 1
Journal of Cranio-Maxillofacial Surgery, 2016
The aim of the present study was to systematically assess the current evidence on the effect of nongrafted compared to graft-assisted maxillary sinus floor elevation on implant survival/failure, endosinus bone gain, crestal bone loss, and bone density around dental implants. Materials and Methods: MEDLINE-PubMed, Cochrane-CENTRAL, and EMBASE databases were searched up to November 2015 for randomized controlled trials (RCTs) and controlled clinical trials-(CCTs), evaluating dental implants placed in combination with maxillary sinus elevation without and with bone grafting. Implant survival/failure served as the primary outcome, whereas endosinus bone gain, crestal bone loss, and bone density around dental implants were secondary outcomes. To assess possible bias, the Cochrane risk of bias tool was used. Data were extracted and a meta-analysis performed where appropriate. Results: Independent screening of 3180 papers resulted in six eligible experiments. Heterogeneity was observed among experiments. One experiment showed low, three unclear, and two a high risk of bias. The assessed outcomes showed no significant longterm differences between groups. Conclusion: Within the limit of the current systematic review, nongrafted maxillary sinus floor elevation seems to be characterized by new bone formation and high implant survival rate comparable to bone-graft−assisted maxillary sinus floor augmentation. Further long-term studies are needed before definitive conclusions can be made.
Materials, 2020
This study aimed to investigate the histological features of deproteinized equine bone mineral (DEBM) and anorganic bovine bone (ABB) after human sinus augmentation with the lateral approach. Twenty-three sinus augmentations were performed in 16 patients (male: 10/female: 6) using DEBM or ABB in a randomized fashion. Healing took place over the next 6 months. Bone core biopsies (N = 23) were obtained for each subject prior to placing the dental implants. The biopsies were processed for both histological descriptions and histomorphometric analysis. Statistical analyses were applied as appropriate, defining statistical significance as p < 0.05. Core bone biopsies revealed no differences in terms of newly formed bone between groups, or differences in terms of tissue inflammation. Both DEBM and ABB appear to be suitable biomaterials for bone augmentation in sinus lift surgery in the short term. However, dedicated studies are required to confirm these results and their stability in th...
Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 2009
The objective of this study was to evaluate the sinus bone graft resorption and marginal bone loss around the implants when allograft and xenograft are used. Study design. Sinus bone grafting and implant placement (Osstem, Korea) were performed on 28 patients from September 2003 to January 2006. In group I, a total of 49 implants were placed in 23 maxillary sinus areas of 16 patients together with bone graft using xenograft (Bio-Oss) and a minimal amount of autogenous bone. In group II, 24 implants were placed in 13 maxillary sinus areas of 12 patients together with bone graft using a minimal amount of autogenous bone and equal amounts of allograft (Regenaform) and Bio-Oss in group II. Results. Early osseointegration failures of 3 implants in 3 patients (group I: 1 patient, 1 implant; group II: 2 patients, 2 implants) were observed, and revisions were performed for these 3 implant sites, followed by complete prosthodontic treatments. The average height of the remaining alveolar bone before the surgery, immediately after the surgery, and 1 year after the surgery was 4.9 mm, 19.0 mm, and 17.2 mm, respectively, in group I. In group II, the average height of the remaining alveolar bone was 4.0 mm, 19.2 mm, and 17.8 mm before the surgery, immediately after the surgery, and 1 year after the surgery, respectively. The average marginal bone loss 1 year after prosthodontic loading and after 20.8 months' follow-up was 0.6 mm and 0.7 mm, respectively, in group I. A 93.9% success rate was observed for group I, with 3 implants showing bone resorption of Ͼ1.5 mm within 1 year of loading. For group II, the average marginal bone loss 1 year after prosthodontic loading and after 19.7 months' follow-up was 0.7 mm and 1.0 mm, respectively. An 83.3% success rate was observed for group II, with 4 implants showing bone resorption of Ͼ1.5 mm within 1 year of loading. Conclusions. Based on the observations in this study, it was concluded that mixed grafting with demineralized bone matrix for maxillary sinus bone grafting has no significant short-term merit regarding bone healing and stability of implants compared with anorganic bovine bone alone.
International Journal of Implant Dentistry
Background Autogenous bone graft is considered as the preferred grafting material for maxillary sinus floor augmentation (MSFA). However, harvesting of extraoral or intraoral autogenous bone graft is associated with risk of donor site morbidity and supplementary surgery. From a clinical and patient perspective, it would therefore be an advantage, if postoperative discomfort could be minimized by diminishing the need for autogenous bone graft harvesting. The objective of the present study was to test the hypothesis of no difference in patient’s perception of recovery after MSFA with autogenous bone graft from the zygomatic buttress (control) compared with 1:1 mixture of autogenous bone graft and deproteinized porcine bone mineral (DPBM) (Test I) or biphasic bone graft material (BBGM) (Test II). Sixty healthy patients were randomly allocated to either control or test groups. Oral Health-related Quality of Life (OHRQoL) was evaluated by Oral Health Impact Profile-14 (OHIP-14) at enroll...
Clinical Oral Implants Research, 2012
Aims: The objective of the present systematic review was to test the hypothesis of no differences in the implant treatment outcome when Bio-Oss or Bio-Oss mixed with autogenous bone is used as graft for the maxillary sinus floor augmentation (MSFA) applying the lateral window technique. Material and methods: A MEDLINE (PubMed) search in combination with a hand search of relevant journals was conducted by including human studies published in English from January 1, 1990 to June 1, 2010. The search provided 879 titles and 35 studies fulfilled the inclusion criteria. Considerable variation in the included studies prevented meta-analysis from being performed and no long-term study comparing MSFA with the two treatment modalities was identified. Also, the survival of suprastructures after the two augmentation procedures was not compared within the same study. Results: The 1-year implant survival was compared in one study demonstrating no statistically significant difference. The implant survival was 96% with Bio-Oss and 94% with a mixture of 80% Bio-Oss and 20% autogenous mandibular bone. Addition of a limited amount of autogenous bone to Bio-Oss seemed not to increase the amount of new bone formation and bone-to-implant contact compared with Bio-Oss. Conclusions: Therefore, the hypothesis of no differences between the use of Bio-Oss or Bio-Oss mixed with autogenous bone as graft for MSFA could neither be confirmed nor rejected.
Clinical Oral Implants Research, 2009
AbstractBackground: To date, there are still no clear cut guidelines for the use of autogenous bone or bone substitutes.Aim: The aim of the present review was to analyze the current literature in order to determine whether there are advantages of using autogenous bone (AB) over bone substitutes (BS) in sinus floor augmentation. The focused question was: is AB superior to BS for sinus floor augmentation in partially dentate or edentulous patients in terms of implant survival, patient morbidity, sinusitis, graft loss, costs, and risk of disease transmission?Materials and methods: The analysis was limited to titanium implants with modified surfaces placed in sites with 6 mm of residual bone height and a lateral wall approach to the sinus. A literature search was performed for human studies focusing on sinus floor augmentation.Results: Twenty-one articles were included in the review. The highest level of evidence consisted of prospective cohort studies. A descriptive analysis of the constructed evidence tables indicated that the type of graft did not seem to be associated with the success of the procedure, its complications, or implant survival. Length of healing period, simultaneous implant placement or a staged approach or the height of the residual alveolar crest, sinusitis or graft loss did not modify the lack of effect of graft material on the outcomes. Three studies documented that there was donor site morbidity present after the harvest of AB. When iliac crest bone was harvested this sometimes required hospitalization and surgery under general anesthesia. Moreover, bone harvest extended the operating time. The assessment of disease transmission by BS was not a topic of any of the included articles.Discussion and Conclusion: The retrieved evidence provides a low level of support for selection of AB or a bone substitute. Clear reasons could not be identified that should prompt the clinician to prefer AB or BS.