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Comparison of Bone Formation After Sinus Membrane Lifting Without Graft or Using Bone Substitute "Histologic and
Amir Zahedpasha1, Alireza Ghassemi2, Ali Bijani3
1Resident, Oral Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
Summary
Graft-less sinus lifts showed comparable radiological bone gain to those using bone substitutes. Histomorphometric analysis revealed superior bone formation in the graft-less group, suggesting the blood clot is an effective medium for bone regeneration.
Area of Science:
- Oral and Maxillofacial Surgery
- Regenerative Dentistry
- Implantology
Background:
- Sinus floor elevation aims to augment bone height in the posterior maxilla for dental implant placement.
- Traditional methods often utilize autogenous bone grafts or bone substitutes, associated with donor site morbidity and increased costs.
- Graft-less techniques offer a potentially simpler and more cost-effective alternative, minimizing surgical complications.
Purpose of the Study:
- To evaluate and compare bone gain after sinus membrane elevation using a graft-less technique versus a bone substitute (Cerabone).
- To assess the quantity and quality of bone regenerated in both groups via radiological and histomorphometric analysis.
- To determine the efficacy of a graft-less approach in simultaneous sinus lift and implant insertion procedures.
Main Methods:
- A randomized, double-blinded, split-mouth clinical trial was conducted involving 10 patients requiring sinus lifts.
- One sinus underwent a graft-less sinus lift (group 1), while the contralateral sinus received Cerabone as a bone substitute (group 2).
- Dental implants were inserted simultaneously in a one-stage procedure, with bone evaluation at 6 months post-surgery.
Main Results:
- Radiological assessment showed similar bone height gain in both groups (6.21 mm graft-less vs. 9.58 mm Cerabone).
- Histomorphometric analysis revealed significantly greater trabecular thickness and bone formation in the graft-less group (P = .003 and P = .002).
- Neovascularization was higher in the graft-less group, though not statistically significant (P = .288).
Conclusions:
- Graft-less sinus lifts achieve comparable radiological bone gain to those using Cerabone.
- Histomorphometric analysis indicates superior bone regeneration and quality in the graft-less group.
- The blood clot appears to serve as an adequate filler and an excellent medium for bone formation in graft-less sinus lifts.
