Biphasic Calcium Phosphate Versus Deproteinized Bovine Bone Mineral for Sinus Floor Elevation: A Systematic Review...

Sinus floor elevation using deproteinized bovine bone mineral (DBBM) is widely used as a grafting material to promote new bone formation. Biphasic calcium phosphate (BCP) has also been utilized to enhance vertical and horizontal bone augmentation prior to dental implant placement. Both materials are considered viable options for sinus augmentation. This systematic review and meta-analysis aimed to evaluate the histological results of BCP compared to DBBM. A systematic search of PubMed, Scopus, Web of Science, and Cochrane Controlled Register of Trials (CENTRAL) was conducted from March 2025 to May 2025 to identify randomized controlled trials (RCTs) comparing BCP versus DBBM in patients undergoing sinus floor elevation. Primary outcomes included the percentage of new bone formation and residual bone graft. The secondary outcome was the percentage change in soft tissue. Pooled mean differences (MD) with 95% confidence intervals (CI) were calculated using a random-effects model. All analyses were performed using Stata/MP Version 18 (StataCorp LLC, College Station, Texas, United States). Ten RCTs involving 328 patients and 389 implants were included. BCP was associated with a higher percentage of new bone formation (MD=3.48; 95% CI: 0.89-5.97; p=0.01; I²=44.03), lower residual grafting materials (MD=-8.41; 95% CI: -13.12 to -3.72; p<0.001; I²=85.71), and higher soft tissue materials (MD=6.01; 95% CI: 2.39-9.63; p<0.001; I²=71.96) compared to DBBM. In conclusion, the adjunctive use of BCP enhances histomorphometric outcomes in sinus floor elevation. Further high-quality, long-term RCTs with standardized protocols are needed to confirm these findings.