Bone formation following sinus grafting with autogenous bone-derived cells and bovine bone mineral in minipigs: preliminary findings.

Bone formation in a sinus grafted with a cell-free scaffold requires the presence of local progenitor cells that differentiate into osteoblasts. The purpose of this study was to examine the effect of culture expanded autogenous bone-derived cells (ABC) with bovine bone mineral (BBM) on bone formation after single-stage sinus grafting in minipigs. Bone biopsies from the iliac crest were harvested 4 weeks prior to sinus grafting and ABC were culture expanded in vitro. The sinuses of five adult minipigs were grafted. In one sinus of each minipig the space between Schneider's membrane (SM) and the sinus wall was grafted with ABC (325,000 cells per sinus, on average) and BBM. In the other sinus, BBM alone was used. The animals were sacrificed after 12 weeks. One block of each grafted area was prepared by saw cutting and the amount of newly formed bone was analysed by micro-computed tomography (mu-CT). The addition of ABC to BBM significantly increased the amount of newly formed bone compared with BBM alone on mu-CT analysis (ABC+BBM: 29.86+/-6.45% vs. BBM: 22.51+/-7.28% (P=0.016)). Bone formation was increased near SM (ABC+BBM: 20.7+/-4.5% vs. BBM: 15.43+/-3.62% (P=0.009)) and in the middle zone of the grafting material (ABC+BBM: 31.63+/-7.74% vs. BBM: 22.5+/-7.91% (P=0.001)), but not near the local host bone (ABC+BBM: 37.23+/-8.23% vs. BBM: 28.42+/-12.54% (P=0.15)). These preliminary findings indicate that supplementation of cell-free grafting material with culture expanded ABC can stimulate bone formation in areas with low bone-forming capacity.