Histologic and histomorphometric evaluation of autogenous bone graft and collagenated xenograft combination with a ratio of 1:3 or collagenated xenograft alone in bilateral sinus augmentation

The purpose of the this study was to evaluate the histologic and histomorphometric results of Autogenous bone (AB)+collagenated xenograft with a ratio of 1:3 and collagenated xenograft alone in bilateral sinus augmentation in patients with bilateral posterior maxillar atrophy.Six patients (4 male, 2 female) with a mean age of 55.00±10.95 and with maximum 5 mm residual alveolar bone height were participated in this study. Following lateral wall osteotomy, maxillary sinuses were augmented bilaterally with collagenated xenograft (Group 1) or AB+collagenated xenograft (Group 2). After grafting, a resorbable collagen membrane (CM) was used to cover the lateral bony window on both sides. Cone Beam Computerized Tomography (CBCT) was used before the sinus augmentations to evaluate residual alveolar bone height, immediately and 8 months after the sinus augmentations to evaluate the height of the available graft. During the implantation bone biopsies were obtained from the grafted areas and histological analysis was performed.No post-operative complications were observed during the healing period. In CBCT analysis performed before the sinus augmentations revealed a mean residual alveolar bone height of 4.14±2.99 mm in Group 1 and 3.24±1.66 mm in Group 2. Immediately after the sinus augmentations average graft heights were 11.91±5.40 mm and 11.35±3.45 mm, 8 months after the sinus augmentations these values were 9.31±4.54 mm and 10.39±3.70 mm in Group 1 and Group 2, respectively. In intergroup analysis, the increase of the mean value immediately after the augmentation and the decrease of the mean value 8 months after the augmentation were found statistically significant in both groups (p<0.05). However, no statistically significant difference was found between the groups (p>0.05). Histologic examinations showed new bone formation in all specimens, but bone formation was more dense in Group 2 compared the Group 1. Histomorphometry showed that newly formed bone %29.4 and %36.6 in Group 1 and 2, respectively. Residual graft particles were %14.4 in Group 1 and %14 in Group 2. Fibrous tissue rate %56 and %49.2 in Group 1 and Group 2, respectively. But no statistically significant difference was found between the groups based on the mean percentage of new bone formation (p>0.05).Within the limits of the study the results showed that 8 months of graft healing time is enough for bone formation in both treatment groups. However no significant difference was found between the groups.