Comparison Between Two Bone Graft Materials in Bilateral Sinus Augmentation

Objectives: The purpose of this study was to compare the performance of two different bone graft materials in the sinus environment using a split-mouth design. A demineralized freeze dried bone allograft incorporated with bone morphogenetic proteins and growth factors, manufactured and marketed as AccellConnexus®, by Keystone Dental (Burlington,MA), compared with the performance of deproteinized bovine bone mineral bone graft, Bio-Oss® product from Osteohealth, (Shirley,NY).

Methods: Each patient (n=10) underwent a bilateral sinus augmentation procedure.  One side utilized the demineralized freeze dried bone allograft and the other side utilized the deproteinized bovine bone mineral bone graft. The piezoelectric system (Piezotome,Acteon,Paris,France) was used to perform the access for the sinus augmentation procedures to enable the grafting. These patients were followed up for six months of healing. Core biopsies were then taken from both sides using a trephine bur system (EasyRetrieve,ACE). These biopsies were labeled and sent for micro-CT sectioning and analysis. Panoramic and CT radiographs were also taken for each patient.

Results: The panoramic and CT radiographs were used to evaluate bone height. Micro-CT analysis was performed for all core samples to evaluate bone density, volume, and degree of mineralization. One patient had bleeding complications postoperatively but not excluded from the study.  The findings were statistically analyzed using t-test and correlations and differences of the results were discussed.

Conclusion: Bone graft materials used in the pneumatized sinus are needed for the placement of implants. The present study suggests increased bone volume and osteoinductivity observed with AccellConnexus while increased bone density observed with Bio-Oss in the maxillary sinus. Both materials showed resorption and notably higher with AccellConnexus. Furthermore, the present study suggests that the use of bone morphogenetic proteins and growth factors in these graft materials may enhance healing with the potential for improved bone to implant contact.