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Human Maxillary Sinuses Augmented With Mineralized, Solvent-Dehydrated Bone Allograft: A Longitudinal Case Series

Annibali, Susanna MD, DDS*; Cristalli, Maria Paola DDS, PhD; La Monaca, Gerardo DDS, PhD; Bignozzi, Isabella DDS; Scarano, Antonio MD, DDS§; Corrado, Rubini MD; Lo Muzio, Lorenzo MD, DDS, PhD

doi: 10.1097/ID.0b013e31823420a4
Basic and Clinical Research
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Background: This prospective case series aimed to assess the clinical stability of maxillary sinus floors regenerated with mineralized, solvent-dehydrated bone allograft (MSDBA) and restored with dental implants after at least 5 years of function.

Materials and Methods: Eleven sinuses in 7 patients (4 bilateral) were augmented with 50% cortical and 50% cancellous MSDBA (Puros, Zimmer Dental Italy srl, Vittorio Veneto, Treviso, Italy). After a mean healing period of 8.1 months, a total of 11 bone specimens (1 per sinus graft) were retrieved and 25 implants were placed. Bone samples were analyzed using histology, histomorphometry, and immunohistochemistry. Standardized periapical radiographs were taken at prosthetic loading (baseline) and annually.

Results: There were no complications or failures. Histologically, almost all residual MSDBA particles were surrounded by bone. Histomorphometry characterized the tissue as 39% ± 1.6% newly formed bone, 34% ± 1.6% marrow spaces, and 31% ± 1.4% residual material reflective of high cortical content of the composite graft. Immunohistochemistry indicated that osteoblasts expressed OB-cadherin at high levels. After a mean follow-up of 5.1 years, implants and regenerated bone appeared clinically stable. Radiographically, implants appeared to be surrounded by dense bone and ridges did not lose clinically measurable volume.

Conclusions: Composite MSDBA allografts formed good quality maxillary sinus bone without complications after 8.1 months of mean healing time, and demonstrated clinical and radiographic stability after a mean follow-up time of 5.14 years.

*Associate Professor, Department of Odontostomatological and Maxillofacial Sciences, Oral Surgery Unit, “Sapienza” University of Rome, Rome, Italy.

†Assistant Professor, Department of Odontostomatological and Maxillofacial Sciences, Oral Surgery Unit, “Sapienza” University of Rome, Rome, Italy.

‡Lecturer, Department of Odontostomatological and Maxillofacial Sciences, Oral Surgery Unit, “Sapienza” University of Rome, Rome, Italy.

§Assistant Professor, Dental School, University of Chieti-Pescara, Chieti, Italy.

∥Professor, Institute of Harmed Anatomy, Department of Neurosciences, Polytechnic University of the Marche, Ancona, Italy.

¶Full Professor, Department of Surgical Sciences, University of Foggia, Foggia, Italy.

Reprint requests and correspondence to: Susanna Annibali, MD, DDS, Department of Odontostomatological and Maxillofacial Sciences, Oral Surgery Unit, School of Dentistry, “Sapienza” University of Rome, Via Caserta, 6 00161, Rome, Italy, Phone: 39-06-49976651, Fax: 39-06-44230811, E-mail: susanna.annibali@uniroma1.it

© 2011 Lippincott Williams & Wilkins, Inc.