Maxillary Bone Microstructure After Lateral Sinus Flour Augmentation with Deproteinized Bovine Bone Material in Severe Alveolar Bone Atrophy: Comparative Micro-CT Study

The most common material used for lateral sinus floor augmentation (LSFA) is xenogenic deproteinized bovine bone (DBB). However, in cases with significantly decreased residual bone height (RBH) (2–3 mm or less) where the osteogenic potential and vasculature of the recipient area are compromised the efficacy of the DBB is debatable. The aim of the study was to investigate the structural properties of the subantral bone regenerate by micro-CT in patients treated for significant alveolar ridge atrophy (RBH less than 3 mm) with LSFA and DBB grafts.

Twenty patients (10 men and 10 women) were included in the study and divided into two groups: (1) the main group–10 patients with edentulous posterior maxilla and RBH less than 3 mm, where LSFA was performed to create the appropriate bone volume for installation of the implants; (2) the control group–10 patients with RBH more than 10 mm and no necessity for bone augmentation procedures. In all patients, the bone samples were taken during the insertion of the implants in the area of interest. All samples were analyzed by micro-CT method. 3-D morphometric parameters were evaluated and compared in both groups.

There were no significant differences in parameters that reflected 3-D morphometric structure and density of the edentulous alveolar bone with sufficient bone volume and augmented bone in patients with RBH less than 3 mm (p > 0.05). The slight differences were observed in trabecular architecture: In operated patients, the lower porosity, bone volume-to-surface ratio, anisotropy rate and increased trabecular pattern factor as a result of continuous functional remodeling process were observed.

Maxillary sinus floor elevation with DBB alone is a strategy, providing an appropriate 3-D architecture of the newly formed bone tissue and adequate primary stability of the dental implants. The biological properties and long-term remodeling of the augmented bone in patients of this category requires the further investigation.