Sequential healing of the elevated sinus floor after applying autologous bone grafting: an experimental study in minipigs

• Published in: Clinical oral implants research 2015-04, Vol.26 (4), p.419-425
• Main Authors: Scala, Alessandro, Lang, Niklaus P., de Carvalho Cardoso, Leandro, Pantani, Fabio, Schweikert, Michael, Botticelli, Daniele
• Format: Article
• Language: English
• Subjects: animal study; Animals; Atrophy; autogenous bone; Autografts; autologous bone; Biocompatibility; Biomedical materials; bone formation; Bone grafts; Bone healing; Bone matrix; Bone Transplantation - methods; Connective tissues; Dental implants; Dentistry; Elevation; Grafting; Healing; implant dentistry; lateral approach; Mandible; Mandible - transplantation; Maxillary sinus; Membranes; Mineralization; Mucosa; Nasal Mucosa - surgery; Osteotomy; Paraffin; Schneiderian membrane; Shrinkage; Sinus Floor Augmentation - methods; sinus floor elevation; Sinuses; Skin & tissue grafts; Substitute bone; Surgery; Swine; Swine, Miniature; Transplantation, Autologous; Wound Healing
• ISSN: 0905-7161; 1600-0501
• DOI: 10.1111/clr.12378

Aim To describe the sequential healing after elevation of the maxillary sinus mucosa applying the lateral access technique with the use of autogenous bone grafting without membrane to occlude the osteotomy access. Material and methods Immediately after the elevation of the maxillary sinus Schneiderian membrane, applying the lateral access technique in 10 minipigs, autologous bone was harvested from the lateral aspect of the mandibular molar region and ground into particles with a bone mill. The space under the Schneiderian membrane was filled with this graft. No membranes were placed onto the access osteotomy. The healing was evaluated after 15, 30, 90 and 180 days. Paraffin sections were prepared and analyzed histologically. Results After 15 days of healing, the elevated area was mainly filled with provisional matrix, newly formed bone and some remnants of bone chips, and appeared reduced in volume compared with that at the time of surgery. After 30 days of healing, further shrinkage of the height of the elevated space was found, with similar percentages of the different tissue components. After 90 and 180 days, the area underneath the Schneiderian membrane appeared reduced in volume and condensed toward the base of the sinus. The bone tissues appeared to be more mature, both for the mineralized and the non‐mineralized portions, while connective tissue occupied 20% of the space, most likely related to the lack of the use of a membrane occluding the access at the time of surgery. Conclusions Suboptimal healing outcomes with respect to augmentation of the space under the sinus floor membrane were documented when autologous bone chips were used as a filler and no membrane was applied to cover the access.