A histomorphometric meta-analysis of sinus elevation with various grafting materials

Several grafting materials have been used in sinus augmentation procedures including autogenous bone, demineralized freeze-dried bone (DFDBA), hydroxyapatite, β-tricalcium phosphate (β-TCP), anorganic deproteinized bovine bone and combination of these and others. Up to now a subject of controversy in maxillofacial surgery and dentistry is, what is the most appropriate graft material for sinus floor augmentation

Comparative Study of Hydroxyapatite Prepared from Seashells and Eggshells as a Bone Graft Material

The aims of this study were to determine the physical properties of hydroxyapatite from seashells (sHA) and from eggshells (eHA), to analyze elements within sHA and eHA, and to compare the bone regeneration ability between sHA and eHA in a rat parietal bone defect model. The sHA and eHA particles had a similar morphology in scanning electron microscope images. From the Fourier-transform infrared absorbance spectra and X-ray diffraction results, both types of hydroxyapatite (HA) had the characteristics of pure HA. Inductively coupled plasma atomic emission spectroscopy results suggested that the sHA had higher levels of sodium and strontium than the eHA, whereas the eHA had higher levels of magnesium than the sHA. In μ-CT results, the mean bone mineral density of the sHA was significantly higher than the control at 4 weeks after the operation (p = 0.012). The mean bone volume of the eHA was significantly higher than the control at 8 weeks after the operation (p = 0.012). In the histological images at 4 weeks after the operation, foreign body multinucleated giant cells were observed around the agglomerated sHA particles, while there were fewer inflammatory reactions around the agglomerated eHA particles. The eHA group showed better results in bone formation than did the sHA group in this study

Histologic and histomorphometric results of three bone graft substitutes after sinus augmentation in humans.

The aim of this study was to compare the histological behavior of three bone graft materials placed in human. The comparison was made among Bio-Oss\uae (BO), Engipore\uae (EP), and PepGen P-15\uae (P-15). Five biopsies for each group of biomaterial, retrieved 6 months after sinus lift augmentation, were analyzed. The investigation was carried out using light microscope (LM), scanning electron microscope (SEM) with an energy dispersive spectrometer (EDS), and circularly polarized light microscope (CPLM). Under LM, the amount of newly formed bone was significantly higher in BO than P-15 (P < .05), while the amount of residual graft material was significantly higher in P-15 than BO (P < .05). The extension of marrow spaces was significantly higher in EP than both BO and P-15 (P < .05). SEM-EDS analysis showed a Ca/P ratio of 1.8 for BO, 2.2 for EP, and 1.5 for P-15. Under CPLM, BO showed no significant difference for transverse (18.4 \ub1 2.7\%) and longitudinal (16.3 \ub1 1.8\%) bone collagen fibers (P = .195); EP showed a significant difference between transverse (4 \ub1 0.7\%) and longitudinal (7.6 \ub1 2.5\%) bone collagen fibers (P = .015); finally, P-15 showed no significant difference for transverse (3.8 \ub1 1.6\%) and longitudinal (4.9 \ub1 1.2\%) bone collagen fibers (P = .279). No investigated biomaterial was completely resorbed, but all the residual particles demonstrated a close bone integration to form a hybrid tissue. BO particles appeared perfectly osseointegrated in the trabecular bone. EP showed a tendency to concentrate the bone apposition into the microporosities; P-15 particles appeared bridged by newly formed bone trabeculae