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Subantral Augmentation With Mineralized Cortical Bone Allograft Material: Clinical, Histological, and Histomorphometric Analyses and Graft Volume Assessments

Berberi, Antoine BDS, MSc, PhD; Nader, Nabih BDS

doi: 10.1097/ID.0000000000000391
Basic and Clinical Research

Purpose: The aim of this study was to clinically and histologically evaluate the effect of using mineralized cortical bone allograft in sinus lift augmentation and to 3-dimensionally quantify volumetric changes in maxillary sinuses augmented over a 2-year period.

Materials and Methods: Eleven patients affected with less than 3 mm of residual ridge were enrolled in the study. After sinus grafting with a mineralized bone allograft, the site was covered with a collagen wound dressing. During implant placement 4 months later, a biopsy was obtained for histological and histomorphometry evaluations. Bone volume changes were also evaluated.

Results: Biopsies showed mature cancellous bone with a predominantly lamellar structure. The well-vascularized intertrabecular spaces were filled with connective tissue and bone marrow. Histomorphometry evaluations revealed a mean 43.76 ± 1.47% of bone marrow, 40.16 ± 1.35% of mineralized bone and 16.59 ± 0.55% of woven bone. The mean of residual particles was 0.47 ± 0.01%. Volumetric measurements showed a mean volume of grafted material 16.24 ± 1.55 cm3 at T0, 14.48 ± 1.48 cm3 at T1, and 13.06 ± 1.39 cm3 at T2. The mean volume retraction was 10.83% of the initial total volume at (T0-T1) and 9.8% at (T1-T2).

Conclusions: The clinical and histological results indicated that mineralized cortical bone allograft promoted de novo bone formation and can be used for sinus lift procedure.

*Professor, Oral and Maxillofacial Surgery Department, School of Dentistry, Lebanese University, Beirut, Lebanon.

Clinical Assistant, Oral and Maxillofacial Surgery Department, School of Dentistry, Lebanese University, Beirut, Lebanon.

Reprint requests and correspondence to: Antoine Berberi, BDS, MSc, PhD, Oral and Maxillofacial Surgery Department, School of Dentistry, School of Dentistry, Lebanese University, PO BOX: 5208-116, Beirut, Lebanon, Phone: +961 3 731173 Fax: +961 4 533060, E-mail:

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