Maxillary sinus augmentation: histomorphometric analysis of graft materials for maxillary sinus floor augmentation

This study used histomorphometric analysis to quantitate the bone composition of four different sinus grafting materials biopsied at the time of implant installation. The study consisted of five patients in whom eight bone biopsies were obtained from seven grafted sites. The grafting materials consisted of hydroxylapatite (HA) granules mixed with cortical chin bone, HA mixed with demineralized bone powder, HA alone, and cortical chin bone alone. Histomorphometry was performed using backscattered scanning electron microscopy images and a computerized image analysis system. The biopsy cores yielded 46 sections from which a total of 255 fields, measuring 2.0 mm x 2.0 mm each, were imaged and analyzed. The biopsy cores contained 44.4% bone after grafting with HA granules and chin bone, 59.4% bone after grafting with chin bone alone, 20.3% bone after grafting with HA granules alone, and 4.6% bone after grafting with HA granules and demineralized bone powder. The small number of biopsies did not permit analysis of statistical significance. However, this study demonstrated the feasibility of correlating mineralized tissue composition of different sinus grafting materials with clinical outcome after dental implant installation.