Volumetric changes and graft stability after lateral window sinus floor augmentation: A randomized clinical trial

Current knowledge about sinus floor augmentation includes established methods using various graft materials. Prior research has shown that lateral window sinus floor augmentation (LWSFA) is a common procedure to increase bone volume for dental implants. However, the long-term stability and volumetric changes of specific graft materials remain unclear. No prior work had resolved the comparative performance of anorganic bovine bone mineral (ABBM) versus a blend of ABBM and mineralized cortical allograft (MCA). This gap motivated the need for a controlled clinical trial to evaluate these materials. Existing studies have not fully addressed the dimensional changes in sinus anatomy following grafting. The lack of precise data on graft volume reduction and membrane thickness changes limits clinical decision-making. This study aims to address these uncertainties by using advanced imaging techniques. Understanding these changes is essential for optimizing implant placement and predicting outcomes.

This study aimed to compare the volumetric stability and dimensional changes of two graft materials used in lateral window sinus floor augmentation. The specific problem addressed was the lack of evidence on how different graft compositions affect postoperative outcomes. The motivation stemmed from the need to determine if one graft material offers superior stability over another. Researchers focused on evaluating anorganic bovine bone mineral (ABBM) alone versus a mixture of ABBM and mineralized cortical allograft (MCA). The study sought to quantify changes in graft volume and sinus dimensions over six months. It also aimed to assess the impact of graft composition on Schneiderian membrane thickness. The goal was to provide clinicians with data to guide material selection. This approach could improve patient outcomes by identifying optimal grafting strategies.

The study employed a randomized clinical trial design with two groups of patients undergoing lateral window sinus floor augmentation. Cone beam computer tomography (CBCT) scans were taken pre-operatively and at two weeks and six months post-surgery. Three-dimensional segmentation analysis was used to measure changes in bone graft volume and height. Linear measurements included lateral window dimensions, residual bone height and thickness, and Schneiderian membrane thickness. Patients were randomly assigned to receive either 100% anorganic bovine bone mineral (ABBM) or a 0.8:1 ratio of ABBM and mineralized cortical allograft (MCA). The study included 16 patients with 20 maxillary sinuses requiring augmentation. Statistical analysis compared volumetric and linear changes between the two groups. The use of CBCT allowed for precise tracking of anatomical changes over time.

The study found no statistically significant difference in bone graft volume reduction between the two groups at six months. Group 1 (ABBM alone) showed a 14.87% ± 16.60% reduction, while Group 2 (ABBM + MCA) had a 18.06% ± 9.81% reduction (p = 0.33). Schneiderian membrane thickness increased significantly after two weeks, with Group 1 showing a 8.70 mm increase compared to 5.70 mm in Group 2. Sinus width correlated weakly with graft height reduction after six months. No other linear measurements revealed significant differences between the groups. The results suggest both graft materials maintain similar dimensional stability. The increase in Schneiderian membrane thickness may influence LWSFA outcomes. These findings support the use of both graft types for sinus augmentation.

The authors concluded that both anorganic bovine bone mineral (ABBM) alone and a mixture of ABBM and mineralized cortical allograft (MCA) are suitable for lateral window sinus floor augmentation. The study found no significant difference in volumetric changes between the two groups at six months. The observed increase in Schneiderian membrane thickness in Group 1 may affect surgical outcomes. The weak correlation between sinus width and graft height reduction suggests anatomical variability. These findings support the use of either graft material for sinus augmentation procedures. The results do not indicate a preference for one material over the other. The study highlights the importance of monitoring dimensional changes post-surgery. These conclusions are based on the specific measurements and analysis methods used in the trial.