Sinus floor augmentation using large (1-2 mm) or small (0.25-1 mm) bovine bone mineral particles: a prospective, intra-individual controlled clinical, micro-computerized tomography and histomorphometric study.

OBJECTIVES

To compare the amount of newly formed bone after sinus floor augmentation with two different particle sizes of bovine bone mineral (BBM) using clinical, micro-computerized tomography (CT) and histological techniques.

METHODS

Bilateral sinus floor augmentations were performed in 10 patients. Six to 9 months later, bone samples were retrieved and analyzed.

RESULTS

Results

Both groups were not different in vertical bone height achieved after augmentation, post-operative complications and maximal torque for the insertion of implants. Micro-CT measurements could not detect a statistically significant difference in bone volume between the groups (with a tendency for new more bone in the small granules group). Histomorphometric analysis revealed that both granule sizes produced the same pattern of bone formation, surrounding the graft granules, and producing a shape of a network, "bridging" between the BBM particles. Multi-nucleated giant cells, probably osteoclasts, were observed directly on the BBM particle surface in both groups. The osteoclast-like cells preferred the small-size BBM particles and not the large particles both in the small-size and the large-size granules group.

CONCLUSION

Both sizes of BBM granules preformed equally and achieved the aim of the sinus floor augmentation procedure clinically and histologically.