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. 2009 Jun 11:5:12.
doi: 10.1186/1746-160X-5-12.

A histomorphometric meta-analysis of sinus elevation with various grafting materials

Jörg Handschel  1 , Melani Simonowska, Christian Naujoks, Rita A Depprich, Michelle A Ommerborn, Ulrich Meyer, Norbert R Kübler
Affiliations

A histomorphometric meta-analysis of sinus elevation with various grafting materials

Jörg Handschel et al. Head Face Med. .

Abstract

Several grafting materials have been used in sinus augmentation procedures including autogenous bone, demineralized freeze-dried bone (DFDBA), hydroxyapatite, beta-tricalcium phosphate (beta-TCP), anorganic deproteinized bovine bone and combination of these and others. Up to now a subject of controversy in maxillofacial surgery and dentistry is, what is the most appropriate graft material for sinus floor augmentation.

Purpose: The aim of this study is to provide a body of evidence-based data regarding grafting materials in external sinus floor elevation concerning the fate of the augmented material at the histomorphological level, through a meta-analysis of the available literature.

Materials and methods: The literature searches were performed using the National Library of Medicine. The search covered all English and German literature from 1995 until 2006. For analyzing the amount of bone the parameter "Total Bone Volume" (TBV) was assessed. TBV is determined as the percentage of the section consisting of bone tissue.

Results: In a relatively early phase after implantation the autogenous bone shows the highest TBV values. Interestingly, the different TBV levels approximate during the time. After 9 months no statistically significant differences can be detected between the various grafting materials.

Conclusion: From a clinical point of view, the use of autogenous bone is advantageous if a prosthetic rehabilitation (with functional loading) is expected within 9 months. In other cases the use of anorganic deproteinized bovine bone in combination with autogenous bone seems to be preferable. Donor side morbidity is ignored in this conclusion.

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Figures

Figure 1
Figure 1
Correlation of TBV and time after grafting. The size of the bubbles reflect the relative weight of the value. Black: Bio Oss®, red: Bio Oss® with autogenous bone, blue: autogeneous bone, green: β-TCP.
Figure 2
Figure 2
TBV after 4 until 9 months. Shown are the values and the SD of the weighted mean. The dashed lines mark the statistical significant differences.
Figure 3
Figure 3
TBV after more than 9 months. Shown are the values and the SD of the weighted mean.
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