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Autogenous bone grafting does not enhance bone repair in maxillary sinuses grafted with β-tricalcium phosphate: a
Luiz Cesar Peruzzo1, Albert Sabin David da Silva Ferreira Corrêa Souza1, Luisa de Lanna Reis Rocha2
1Department of Health Sciences, Implantology Post Graduation Course, Dental School, University Center of Araraquara (UNIARA), Araraquara, São Paulo, Brazil.
Objective:
This split-mouth randomized controlled trial evaluates whether the combination of autogenous bone (AB) graft with β-tricalcium phosphate (β-TCP) provides advantages in bone availability following maxillary sinus floor elevation.
Materials And Methods:
Fifteen patients underwent bilateral maxillary sinus floor elevation surgery. The sinus cavities were randomly filled either with β-TCP or with a 1:1 mixture of β-TCP and autogenous bone graft. Ten months after grafting, dental implants were placed. Implant stability was assessed through insertion torque and resonance frequency analysis. Histomorphometry were performed on biopsies obtained at the time of implant placement. Cone-beam computed tomography was used to evaluate bone availability.
Result:
The implant insertion torque was 37.71 ± 14.52 Ncm in βTCP + AB and 41.88 ± 15.80 Ncm in βTCP grafted areas. Sinuses grafted with β-TCP + AB showed 43.75 ± 13.67% of bone while sinuses grafted with β-TCP presented 49.32 ± 13.41% of bone. The linear height in sinuses grafted with β-TCP + AB were 3.38 ± 1.56 mm at baseline, 14.18 ± 3.54 mm at 14 days post-surgery, and 12.12 ± 3.54 mm at 10 months post-surgery. The sinuses grafted with βTCP presented linear heights of 3.17 ± 1.51 mm at baseline, 15.62 ± 2.41 mm at 14 days post-surgery, and 11.81 ± 2.12 mm at 10 months post-surgery. The use of β-TCP alone was associated with greater graft volume reduction than β-TCP+AB, and this difference was more pronounced in sinuses with lower residual bone height.
Conclusion:
After 10 months of healing, the addition of AB to β-TCP did not increase the amount of newly formed bone in maxillary sinus grafts. However, β-TCP alone was associated with greater graft volume reduction, particularly in more atrophic sinuses.
Clinical Relevance:
The addition of AB to β-TCP did not enhance histological bone formation after 10 months of healing, although it improved graft volume maintenance, particularly in more atrophic sinuses.
