Sinus augmentation - autograft vs. fresh frozen allograft: Bone density dynamics and implant stability

J Stomatol Oral Maxillofac Surg. 2021 Nov;122(5):467-471. doi: 10.1016/j.jormas.2020.08.012. Epub 2020 Sep 29.

Abstract

Objectives: Compare bone density changes and initial implant stability following sinus augmentation with autogenous bone (AB) vs. fresh frozen bone (FFB).

Materials and methods: Randomized, prospective, split mouth study. Sinus augmentation executed using either AB or FFB. Dental implants were inserted after 6 months of healing. Implant dimensions and insertion torques were recorded. Prostheses were delivered 6 months thereafter. All patients had computerized tomography (CT) scans 1 week (T1) and 6 months (T2) after initial bone grafting. Third CT (T3) was taken 12 months after prosthesis delivery. Data from CT scans was used to analyze bone density at each period.

Results: A total of 15 patients (8 males, 7 females) following bilateral sinus augmentation procedures, were included. Mean age was 54 ± 5 years (range 48-60 years). All patients had 3 CT examinations. The initial augmented AB density was higher than the initial FFB density. Nevertheless, density differences between the two groups were not statistically significant at any time frame. At T2 density of both grafts showed a statistically significant increase. A significant increase from T2 to T3 was noted only for the FFB group. Implant insertion torque was significantly higher in the FFB group. Insertion torque ≥32 N/cm was achieved in significantly more patients in the FFB group.

Conclusion: The use of FFB for sinus augmentation is a reliable option of graft material. The newly formed bone quality performance, evaluated by CBCT density, is as good as AB, allowing predictable initial implant stability and osseointegration. Unnecessary morbidity associated with AB harvesting is thus avoided.

Keywords: Allograft; Autogenous bone graft; Density; Implant stability; Insertion torque; Sinus augmentation.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Allografts
  • Autografts
  • Bone Density*
  • Dental Implants*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies

Substances

  • Dental Implants