Analysis of the healing process in sinus bone grafting

Objectives: The purpose of this study was to compare differences in the healing process among autogenous bone and xenogeneic bone mixture groups.

Methods: The maxillary sinus bone grafts were divided into four groups according to the graft material used: Group 1, a mixture of autogenous bone and BioOss (Osteohealth Co., USA); Group 2, a mixture of BioOss and Orthoblast II (Greencross, ISOTIS, USA); Group 3, BioOss only; and Group 4, synthetic bone, OSTEON (GENOSS, Korea), only. For Group I, particulate autogenous bone, harvested from the ramus or mandibular symphysis, was mixed with BioOss at a volume ratio of approximately 26 50% using a tissue adhesive (Greenplast; Korea). For Group 2, BioOss and Orthoblast II were mixed at a ratio of 1:2. Groups 2, 3, and 4 were transplanted also using a small amount of autogenous bone harvested from the maxillary sinus bony window and the maxillary tuberosity. Hematoxylin and eosin staining and Goldner's trichrome staining, and examined by light microscopy. Histomorphometric examination and statistical analysis of each group according to time point was performed by the Kruskal-Wallis validation method.

Results: There were no statistically significant differences in the bone density, LB/WB ratio, or NB/GM ratio of the 4-month samples or the 6-month samples between any of the groups.

Conclusion: It was concluded that good bone healing was achieved even for grafts of xenogeneic bone only or synthetic only. Cases grafted with a mixture of allogeneic and xenogeneic bone showed no great advantage with regard to bone healing. This is an encouraging result, considering the burden of additional surgery for autogenous bone grafts and the high cost of commercially available allogeneic bone.