Sinus augmentation - autograft vs. fresh frozen allograft: Bone density dynamics and implant stability - 04/10/20

Doi : 10.1016/j.jormas.2020.08.012

Liat Chaushu ^a , Erick Ricardo Silva ^b , Vitor Ferreira Balan ^c , Gavriel Chaushu ^d,⁎ , Samuel Porfirio Xavier ^e
^a Attending, Department of Periodontology and Implant Dentistry, School of Dentistry, Tel Aviv University, Israel
^b Attending, Department of Oral and Maxillofacial Surgery and Periodontology School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
^c MSc Student in Oral and Maxillofacial Surgery - Dental School of University of Sao Paulo - Ribeirão Preto, University of São Paulo, São Paulo, Brazil
^d Department of Oral & Maxillofacial Surgery, School of Dental Medicine, Tel Aviv University, Tel-Aviv, Department of Oral & Maxillofacial Surgery, Rabin Medical Center, Campus Beilinson, Petah Tiqwa, Israel
^e Department of Oral and Maxillofacial Surgery and Periodontology. School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo, Brazil

^⁎Corresponding author.

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Abstract

Objectives

Compare bone density changes and initial implant stability following sinus augmentation with autogenous bone (AB) vs. fresh frozen bone (FFB).

Materials and methods

Randomized, prospective, split mouth study. Sinus augmentation executed using either AB or FFB. Dental implants were inserted after 6 months of healing. Implant dimensions and insertion torques were recorded. Prostheses were delivered 6 months thereafter. All patients had computerized tomography (CT) scans 1 week (T1) and 6 months (T2) after initial bone grafting. Third CT (T3) was taken 12 months after prosthesis delivery. Data from CT scans was used to analyze bone density at each period.

Results

A total of 15 patients (8 males, 7 females) following bilateral sinus augmentation procedures, were included. Mean age was 54 ± 5 years (range 48–60 years). All patients had 3 CT examinations. The initial augmented AB density was higher than the initial FFB density. Nevertheless, density differences between the two groups were not statistically significant at any time frame. At T2 density of both grafts showed a statistically significant increase. A significant increase from T2 to T3 was noted only for the FFB group. Implant insertion torque was significantly higher in the FFB group. Insertion torque ≥32 N/cm was achieved in significantly more patients in the FFB group.

Conclusion

The use of FFB for sinus augmentation is a reliable option of graft material. The newly formed bone quality performance, evaluated by CBCT density, is as good as AB, allowing predictable initial implant stability and osseointegration. Unnecessary morbidity associated with AB harvesting is thus avoided.

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Keywords : Sinus augmentation, Allograft, Autogenous bone graft, Density, Insertion torque, Implant stability