Amir Zahedpasha1, Alireza Ghassemi2, Ali Bijani3, Sina Haghanifar4, Maryam Seyed Majidi5, Zahra Malekpour Ghorbani6. 1. Resident, Oral Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran. 2. Consultant Oral and Maxillofacial Surgeon, Medical Faculty University RWTH Aachen, Aachen, Germany. 3. Assistant Professor, Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran. 4. Professor, Oral Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran. 5. Professor, Dental Materials Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran. 6. Assistant Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran. Electronic address: ta_malekpour@yahoo.com.
Abstract
PURPOSE: Sinus floor elevation without using autogenous bone graft or bone substitute will eliminate donor site morbidity and reduce the cost and the risk of infection. We evaluated the bone gain after sinus membrane elevation without graft or using bone substitute in the same maxilla. Dental implants were inserted simultaneously as a 1-stage procedure. PATIENTS AND METHODS: In a split-mouth design, we conducted a randomized double-blinded clinical trial performing sinus lifts and simultaneous implant insertion in 10 healthy patients (n = 20). On the 1 site, we performed graft-less sinus lift (group 1) and on the other site Cerabone was used as bone substitute (group 2), respectively. The quantity and quality of bone gained in each sinus were evaluated and compared radiologically and histomorphometrically. RESULTS: After 6 months, the average gain of bone height was 6.21 and 9.58 mm in group 1 and 2, respectively, as measured radiologically (P < .001, P < .001). Histomorphometric examination showed significantly higher thickness of trabeculae and bone formation in group 1 (P = .003 and P = .002). However, the neovascularization was higher, but not significantly (P = .288). CONCLUSIONS:Radiological bone gain was similar in both groups. However, histomorphometric examination showed superior bone formation in graft-less group as compared to the Cerabone group. The blood clot seems to be an adequate filler and excellent medium for bone formation. More studies in split-mouth design are needed to compare different bone substitutes.
RCT Entities:
PURPOSE: Sinus floor elevation without using autogenous bone graft or bone substitute will eliminate donor site morbidity and reduce the cost and the risk of infection. We evaluated the bone gain after sinus membrane elevation without graft or using bone substitute in the same maxilla. Dental implants were inserted simultaneously as a 1-stage procedure. PATIENTS AND METHODS: In a split-mouth design, we conducted a randomized double-blinded clinical trial performing sinus lifts and simultaneous implant insertion in 10 healthy patients (n = 20). On the 1 site, we performed graft-less sinus lift (group 1) and on the other site Cerabone was used as bone substitute (group 2), respectively. The quantity and quality of bone gained in each sinus were evaluated and compared radiologically and histomorphometrically. RESULTS: After 6 months, the average gain of bone height was 6.21 and 9.58 mm in group 1 and 2, respectively, as measured radiologically (P < .001, P < .001). Histomorphometric examination showed significantly higher thickness of trabeculae and bone formation in group 1 (P = .003 and P = .002). However, the neovascularization was higher, but not significantly (P = .288). CONCLUSIONS: Radiological bone gain was similar in both groups. However, histomorphometric examination showed superior bone formation in graft-less group as compared to the Cerabone group. The blood clot seems to be an adequate filler and excellent medium for bone formation. More studies in split-mouth design are needed to compare different bone substitutes.