Histomorphometric Analysis of Maxillary Sinus Grafts: A Pilot Study

Area of Science:

• Oral and Maxillofacial Surgery
• Regenerative Medicine
• Biomaterials Science

Background:

• Maxillary sinus grafting (MSG) is a common procedure to augment bone volume in the posterior maxilla.
• The choice of bone graft material significantly influences the success of MSG and subsequent dental implant placement.
• Evaluating the osteogenic potential of different biomaterials is crucial for optimizing treatment outcomes.

Purpose of the Study:

• To compare the degree of new bone formation following maxillary sinus graft (MSG) using three distinct bone graft materials.
• To histomorphometrically analyze and evaluate bone quality after grafting with anorganic bovine bone mineral (ABBM), anorganic equine bone mineral (AEBM), and mineralized cancellous bone allograft (MCBA).

Main Methods:

• A pilot study involving patients with an edentulous posterior maxilla undergoing a two-stage MSG procedure.
• Random assignment of one of three graft materials (ABBM, AEBM, MCBA) to each sinus.
• Bone core samples retrieved at least 8 months post-grafting were analyzed for vital bone percentage (VB%), residual bone materials (RBM%), and connective tissue (CT%).

Main Results:

• Histomorphometric analysis revealed significant differences in VB%, RBM%, and CT% among the graft materials (P < .05).
• Mineralized cancellous bone allograft (MCBA) group showed significantly higher VB% (32.0%) compared to ABBM (10.9%) and AEBM (9.1%).
• MCBA group had significantly lower RBM% (5.5%) compared to ABBM (34.3%) and AEBM (38.9%). No significant difference was found between ABBM and AEBM.

Conclusions:

• Mineralized cancellous bone allograft (MCBA) resulted in significantly greater new bone formation compared to ABBM and AEBM.
• Anorganic equine bone mineral (AEBM) demonstrated comparable histomorphometric results to anorganic bovine bone mineral (ABBM).
• The findings suggest MCBA is a more effective material for promoting new bone formation in maxillary sinus grafts.