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

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

doi: 10.1097/ID.0b013e3181e59b32
Basic and Clinical Research
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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.

*Adjunct Clinical Assistant Professor, Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI.

†Associate Professor, Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI.

‡Misch International Implant Institute, USA; Adjunct Clinical Assistant Professor, Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI.

§Associate Professor, Department of Oral Surgery and Implant Dentistry, University of Granada School of Dentistry, Granada, Spain.

∥Assistant Professor, Department of Periodontics and Oral Medicine, Division of Radiology, University of Michigan School of Dentistry, Ann Arbor, MI.

¶Associate Professor and Director of Graduate Periodontics, Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI.

Reprint requests and correspondence to: Gustavo Avila, DDS, MS, PhD, Adjunct Clinical Assistant Professor, Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, 1101 N. University, Ann Arbor, MI 48109-1078, Telephone: 734-763-3325, Fax: 734-936-0374, E-mail: avila@umich.edu

© 2010 Lippincott Williams & Wilkins, Inc.