Bone Graft Osseous Changes After Maxillary Sinus Floor Augmentation: A Systematic Review.

Area of Science:

• Oral and Maxillofacial Surgery
• Regenerative Medicine
• Biomaterials Science

Background:

• Lateral sinus floor augmentation is crucial for atrophic posterior maxilla reconstruction.
• Evaluating bone-grafting materials for volumetric bone gain is essential for predictable outcomes.
• Computed tomographic scans provide objective volumetric assessment.

Approach:

• Systematic review of randomized controlled trials (RCTs) published until June 2021.
• Included studies assessed autogenous bone (AB), allografts (AG), xenografts (XG), and alloplastic bone (AP) individually and in combination.
• Outcome measured was graft volume using cone beam computerized tomographic (CBCT) scans.

Key Points:

• All bone graft materials showed volumetric reduction at 6 months post-augmentation.
• Allografts + xenografts (AG+XG) demonstrated the largest volumetric gain.
• Autografts exhibited high resorption rates and inferior volumetric increase compared to some combinations.

Conclusions:

• Grafting material combinations offer significant advantages for new bone formation.
• Alloplastic bone alone showed less volumetric gain than AG+XG and XG with growth factors.
• Further high-powered RCTs are needed to understand topographical variables and optimize material selection.