Fresh-frozen bone: case series of a new grafting material for sinus lift and immediate implants

Although autologous bone is considered to be the gold standard grafting material, it needs to be harvested from patients, a process that can be off-putting and can lead to donor site morbidity. For this reason, homologous fresh-frozen bone (FFB) was used in the current study as an alternative graft material.

The aim of this study was to evaluate the effectiveness of FFB as a grafting material in complex maxillary sinus lift with immediate implant insertion.

FFB was obtained from the Veneto Tissue Bank and preserved at -80 degrees C. Twenty-one patients were surgically treated with FFB block grafts in 26 maxillary sinus rehabilitations, with 47 immediate implant insertions, with a reopening phase after six months. All patients underwent orthopanoramic X-rays and CT scans before, immediately after and four months (X-ray only) post surgery. Bone biopsies were performed in order to evaluate the volume and density of the bone grafts, which all showed optimal adherence without complications.

Four months post surgery, 64% of grafts showed no evidence of bone resorption or resizing. In all other cases resorption was slight. All implants were clinically osseointegrated, with only one implant failure during the provisional prosthetic loading stage (97.8% success rate). Histological studies confirmed these results, showing the presence of new bone and sparse osteoclastic activity four months post implantation, with 80% mature bone material observed after 12 months.

Use of FFB permits effective bone-adding surgery and immediate implant insertion under local anaesthesia, decreasing both chair time and patient discomfort.