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MinerOss® abstracts

Clinical and Histologic Outcomes After the Use of a Novel Allograft for Maxillary Sinus Augmentation: A Case Series

Gustavo Avila, DDS, MS, PhD, Rodrigo Neiva, DDS, MS, Carl E. Misch, DDS, MDS, PhD(hc), Pablo Galindo-Moreno, DDS, PhD, Erika Benavides, DDS, PhD, Ivan Rudek, DDS and Hom-Lay Wang, DDS, MSD, PhD


Purpose:
To document the clinical and histologic outcomes of sinus augmentation using a novel allogenic bone substitute as a sole grafting material.


Materials:
Patients in need of sinus augmentation before implant placement were recruited for this study. Sinus augmentation procedures were performed following a lateral approach, using a freeze-dried allograft as the only grafting material. Patients were followed up postoperatively for 6 months. Plaque score, wound healing, and patient discomfort were recorded at each follow-up visit. Implants were placed between 6 and 7 months after sinus augmentation and restored 6 months later. Bone core biopsy specimens were harvested at the time of implant placement and processed for histologic and histomorphometrical analysis. Vital bone, remaining allograft (RA) particles, and nonmineralized tissue percentages were assessed on each sample. Results were expressed as mean percentages with SD.


Results:
Of the 23 sinus patients, 20 patients underwent sinus augmentation surgery. All patients had satisfactory postoperative healing in the absence of complications. A total of 39 implants were placed. One implant failed and was replaced 3 months later. Histologic analysis revealed the presence of well-organized lamellar bone, in direct contact with RA particles. Mean vital bone was 23.02 ± 19.11%, mean RA was 22.25 ± 20.30%, and average nonmineralized tissue was 54.73 ± 13.51%. Conclusion: Clinical and histologic findings support the suitability of an allograft consisting of a combination of cortical and cancellous chips for sinus augmentation procedures.

©Implant Dent 2010;19:330-341


The influence of the Bucco-palatal distance on Sinus Augmentation Outcomes

Gustavo Avila, Hom-Lay Wang, Pablo Galindo-Moreno, Carl E. Misch, Robert A. Bagramian, Ivan Rudek, Erika Benavides, Ildefonso Moreno-Riestra, Thomas Braun, and Rodrigo Neiva


Background:
Maxillary sinus augmentation is one of the most reliable implant site development options to increase vertical bone height. However, graft consolidation requires adequate angiogenesis and migration of cells involved in osteogenesis and bone remodeling. It is speculated that these biologic events are greatly determined by the dimensions of the maxillary sinus cavity. Hence, the purpose of this study is to assess the influence of the distance from the lateral to the medial wall of the maxillary sinus on the outcomes of sinus augmentation procedures.


Methods:
Maxillary sinus augmentation is one of the most reliable implant site development options to increase vertical bone height. However, graft consolidation requires adequate angiogenesis and migration of cells involved in osteogenesis and bone remodeling. It is speculated that these biologic events are greatly determined by the dimensions of the maxillary sinus cavity. Hence, the purpose of this study is to assess the influence of the distance from the lateral to the medial wall of the maxillary sinus on the outcomes of sinus augmentation procedures.


Results:
Twenty-one patients underwent sinus augmentation for a total of 24 sinuses; however, the data analyzed contained only one sinus per patient. One sinus developed an infection after grafting, resulting in a 96% success rate for the sinus grafting procedure. Twenty sinuses were used in the final statistical analysis. Histomorphometric analysis revealed that mean %VB was 22.71 ± 19.08, mean percent of remaining allograft 23.39 ± 20.85, and average percent of non-mineralized connective tissue was 53.90 ± 13.23. Analysis of the correlation between %VB and BPD by linear regression, using the actual values of BPD showed a strong negative association (R2=0.141;P<0.001).


Conclusion:
The findings suggested that %VB formation after maxillary sinus augmentation is inversely proportional to the sinus BPD.

©J Periodontal 2010:81:1041-1050


Histological, Histomorphometric, and Radiographic Evaluation of a Sinus Augmentation with a New Bone Allograft: A Clinical Case Report

Ricardo Gapski, BDS, DDS, MS, Carl Misch, DDS, MS, PhD, David Stapleton, DDS, Stephanie Mullins, DDS, MS, Charles Cobb, DDS, MS, PhD, Asvin Vansanthan, DDS, MS and Marc Reissner, DDS


Purpose:
This case report documents the histological, histomorphometric, and radiographic effects of a few radiated-preserved bone allograft for sinus elevation procedure.


Materials and Methods:
This unique bone substitute differs from other forms of bone allograft processed through the standard cryopreservation method. Histology from bone biopsy core samples revealed newly formed bone with a well-organized lamellar bone structure in general and remaining particles were observed in contact with surrounding newly-formed bone.


Results:
±6.77% graft resorption from baseline to 6 months.


Conclusion:
The outcome of this report suggests that this bone allograft could be successfully used in sinus lifting procedures. It encourages further research of this radiated-preserved bone allograft material in oral and maxillofacial reconstruction.

©Implant Dent 2008;17:430-438