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Sinus Floor Augmentation With Ambient Blood and an Absorbable Collagen Sponge

A Prospective Pilot Clinical Study

Berberi, Antoine BDS, MSc, PhD*; Nader, Nabih BDS; Bou Assaf, Rita BDS, MSc; Fayyad-Kazan, Hussein PhD; Khairalah, Saad MD§; Moukarzel, Nabil MD

doi: 10.1097/ID.0000000000000631
Basic and Clinical Research

Purpose: The aim of this study was to clinically, radiologically, and histologically evaluate a sinus augmentation technique using a resorbable collagen sponge to maintain space between the Schneiderian membrane and the residual crestal bone.

Materials and Methods: Patients with partially edentulous maxillae were clinically and radiographically evaluated for implant placement. A total of 10 consecutive patients with the bone height for implant placement (<4.0 mm) were enrolled in the study. The lateral maxillary wall was surgically exposed and the Schneiderian membrane was carefully elevated. A collagen wound dressing was placed in the antral area between the sinus floor and the raised membrane. The vertical sinus floor height was calculated using cone-beam computed tomography before the surgical procedure (baseline) and at 6 months postoperative. Immediately after the second scan, a core biopsy was removed for histological evaluation. The biopsy site was then further prepared for implant placement in the same location.

Results: Biopsies showed mature cancellous bone with a predominantly lamellar structure. Well-vascularized intertrabecular spaces were filled with connective tissue and bone marrow. Analysis of bone height changes showed significant mean (SD) differences before and after procedures in anterior (2.67 ± 0.62 mm and 11.15 ± 1.1 mm), medial (2.98 ± 0.55 mm and 10.96 ± 0.77 mm), and posterior (3.17 ± 0.91 mm and 10.63 ± 0.51 mm) maxillary jaw locations (P = 0.005).

Conclusion: The collagen sponge provided an effective substrate for osseous regeneration of the sinus floor.

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

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

Professor, Laboratory of Cancer Biology and Molecular Immunology, Department of Biology, Faculty of Science I, Lebanese University, Beirut, Lebanon.

§Professor, Department of Pathology, Faculty of Medicine, Lebanese University, Beirut, Lebanon.

Assistant Professor, Department of Ear Nose and Throat, Faculty of Medicine, Lebanese University, Beirut, Lebanon.

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

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