Histological and clinical evaluation of 3 different grafting materials for sinus lifting procedure based on 8 cases

Background: The reconstruction of edentulous patients with adequate bone volume and density by using dental implants has become a viable treatment option with high predictability. However, initial stabilization is difficult to achieve in the posterior maxillary regions where cortical bone is thin or absent due to severly resorbed alveolar ridges. Maxillary sinus lift procedures applied with various grafting materials enable clinicians to place implant-supported prostheses even in cases with increased pneumatization of the maxillary sinus. Methods: The purpose of this study was to evaluate histologically and clinically different grafting materials used in maxillary sinus floor augmentation. Deproteinized bovine bone granules (DBBG), demineralized freeze-dried bone powder (DFBP), and porous hydroxyapatite (PHA) were used as grafting materials. A total of 19 implants in 8 patients were placed into grafted sites. In 3 patients, a 2-stage approach was used wherein implants were inserted after a 6-month healing period following a sinus lift procedure. Specimens were taken with a trephine drill, and the site of the specimen was enlarged to accept an implant. For the remaining cases, a 1-stage approach, which included sinus lifting and implant placement, was used and bone biopsies were taken during the uncovering stage. After 6 months of healing, fixed prosthetic restorations were fabricated. Results: The healing period progressed without any complications, and all implants were loaded. The mean functioning time was 12 months, varying from 9 to 24 months. Conclusion: The results indicate that DFBP resorbs earlier than PHA and DBBG in sinus lift procedures.