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European Journal of Oral and Maxillofacial Surgery 2020 December;4(3):79-84

DOI: 10.23736/S2532-3466.20.00213-1

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Heterologous bone block graft versus particulated bone graft: a comparative clinical study, in sinus lift procedures

Corrado TORO 1 , Paola COSTA 2, Corrado NOLFO 1

1 Unit of Maxillofacial Surgery, Clinica del Mediterraneo Private Hospital, Ragusa, Italy; 2 DMD Private Practice, Catania, Italy



BACKGROUND: The sinus lift procedure is a successful and predictable approach for augmentation of the posterior maxilla with deficient crestal bone. Different types of biomaterials are used for sinus augmentation, including autologous bone, heterologous bone, and other biomaterials. Autologous bone is the golden standard for all bone regeneration surgeries, and it can also be used for sinus augmentation, but the increased morbidity makes it less desirable. As regards the heterologous bone grafts, the particulate bone is the most used type, although the efficiency of the bone block has also been proven. In the case of heterologous bone graft, during a sinus lift, the existing literature does not provide evidence regarding differences with the use of the block compared to the granules.
METHODS: This study was designed as an observational clinical study, to assess the clinical outcome of bone regeneration in patients who underwent maxillary sinus augmentation with heterologous bone block and particulate bone. 178 patients were selected. Of these patients, 39 patients were scheduled to undergo bilateral sinus augmentation, and 139 patients were scheduled to undergo monolateral sinus augmentation. A total number of 217 sinus lifts were planned. The 217 procedures (each sinus) were randomly assigned to two different groups: group A and group B. Group A comprised 121 sinus augmentations with particulate heterologous bovine bone. Group B comprised 96 sinus augmentations with heterologous bovine cancellous bone block. Nine months after the surgery a CT exam was requested in order to assess CT was used to perform a detailed, quantitative analysis of an entire implantation site, before implants placement. Ten months after the surgery, bone specimens were collected and implants were simultaneously placed.
RESULTS: The results of the study, confirmed that the heterologous bone block is as reliable as the particulate heterologous bone. However, the block is difficult to handle and shape and the surgical procedure lasts more than usual.
CONCLUSIONS: The particulate bone remains the best choice for sinus augmentation, but the bone block might be useful when the Schneiderian membrane has been perforated, in order to avoid particulate graft migration and to safely complete the procedure.


KEY WORDS: Sinus floor augmentation; Bone transplantation; Biocompatible materials

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