Boyne PJ, James RA. Grafting of the maxillary sinus floor with autogenous marrow and bone

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    • "The ideal material for bone grafting should be biocompatible, induce no host rejection, present no risk of disease transmission, promote support for bone regeneration, and have mechanical stability from the outset, which should be maintained throughout the healing period [1]. The maxillary sinus floor elevation technique described by Tatum and published by Boyne and James in 1980 [2] described autologous bone as the filling material for the sinus cavity, which is still regarded as the gold standard in bone reconstruction. If, on the one hand, autologous grafts present osteoconductive, osteoinductive, and osteogenic potential [3], on the other, they present some risks [4]. "
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    ABSTRACT: Purpose. To investigate the regenerative results obtained with the association of bone marrow aspirate concentrate using the Bone Marrow Aspirate Concentrate (BMAC) method to a xenogeneic bone graft (Bio-Oss) in sinus floor elevation. Materials and Methods. Using a randomized controlled study design in eight consecutive patients (age of 55.4 ± 9.2 years), 16 sinus floor lift procedures were performed with Bio-Oss alone (control group, CG, í µí±› = 8) or combined with bone marrow aspirate concentrate obtained via the BMAC method (test group, TG, í µí±› = 8). Six months after the grafting procedures, bone biopsies were harvested during implant placement and were analyzed by histomorphometry. Results. Histomorphometric analysis revealed a significantly higher amount (í µí± < 0.05) of vital mineralized tissue in TG when compared to the CG (55.15 ± 20.91% and 27.30 ± 5.55%, resp.). For nonvital mineralized tissue, TG presented a statistically higher level of Bio-Oss resorption (í µí± < 0.05) when compared with the CG (6.32 ± 12.03% and 22.79 ± 9.60%, resp.). Both groups (TG and CG) showed no significantly different levels (í µí± > 0.05) of nonmineralized tissue (38.53 ± 13.08% and 49.90 ± 7.64%, resp.). Conclusion. The use of bone marrow concentrate obtained by BMAC method increased bone formation in sinus lift procedures.
    International Journal of Biomaterials 10/2015; 2015(2015):1-7. DOI:10.1155/2015/121286
    • "Due to the immunotolerance and the resulting bone quality, the gold standard for this procedure is still autologous bone harvested from the jaw or the iliac crest (Block and Kent, 1997, Boyne and James, 1980, Browaeys et al., 2007, Stricker et al., 2003, Wood and Moore, 1988, Klijn et al., 2010). "
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    ABSTRACT: Purpose: To investigate the amount of the mineralization of a bovine bone substitute material in sinus floor augmentation after healing times of three and six months. Materials and methods: 51 patients were randomized into two healing time groups and received sinus floor augmentations with a bovine bone material. After three or six months of healing, trephine bone biopsies were retrieved. The biopsies were processed for histologic and histomorphometric evaluations to primarily investigate the amount of mineralized bone in the augmented area and secondarily compare the amount of mineralized bone in the augmented area and in the pristine bone. Statistical tests were performed to analyse the fraction of the mineralized bone (p<.05). Results: The biopsies of both groups showed remnants of the well-integrated bone substitute material. The histology revealed osteoblasts, osteocytes with osteoid, and osteoclasts. The mean percentage of mineralized bone in the augmented area was 23.8% (three months group) and 23.6% (six months group; p=.9246); the amount of remaining bone substitute material was 35% (three months group) and 33.9% (six months group; p=.6325). Conclusion: It can be concluded that the bone maturation in the augmented sinus using the bovine bone material is similar after three and six months. Thus, implant installation after three months following a lateral window sinus floor augmentation approach using a bovine bone material seems to be clinically acceptable. This article is protected by copyright. All rights reserved.
    Journal Of Clinical Periodontology 10/2015; DOI:10.1111/jcpe.12466 · 4.01 Impact Factor
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    • "In presence of severe postextractive resorption, many techniques have been described to augment the residual bone ridge by using the possibility of the sinus membrane elevation up to 5 mm without any tearing [1]. The sinus lift technique was firstly described by Boyne and James [2] and it was based on a modification of the Caldwell-Luc sinus revision, basically consisting in a lateral approach to the sinus that allows a remarkable bone augmentation >10 mm even in very atrophic ridge [1]; this approach is well documented in literature and has proven to be safe and highly predictable. "
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    ABSTRACT: Aim. The aim of this study was to assess the success and the survival rate of dental implants placed in augmented bone after sinus lifting procedures. Material and Methods. 31 patients were mainly enrolled for a residual upper jaw crest thickness of 3 mm. CBCT scans were performed before and after the augmentation technique and at the follow-up appointments, at 3, 6, 12, 24, and up to 60 months. The follow-up examination included cumulative survival rate of implants, peri-implant marginal bone loss, and the height of sinus floor augmentation. Results. This retrospective study on 31 patients and 45 implants later inserted in a less than 3 mm crest showed excellent survival rates (99.5%), one implant was lost before loading due to an acute infection after 24 days, and two implants did not osteointegrate and were removed after 3 months. The radiological evaluation showed an average bone loss of 0.25 mm (±0.78 mm) at the first follow-up appointment (3 months) up to 0.30 mm (±1.28 mm) after 60-month follow-up. Conclusion. In this study it was reported how even in less than 3 mm thick crest a transcrestal technique can predictably be used with a long-term clinical and radiological outcome, giving patients excellent stability of the grafted material and healthy clinical results.
    International Journal of Dentistry 09/2015; 2015(8). DOI:10.1155/2015/261652
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