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The effect of anatomy on osteogenesis after maxillary sinus floor augmentation: a radiographic and histological analysis

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Abstract

Objectives

To assess how anatomy and osteogenesis correlated with results of maxillary sinus floor augmentation (MSFA).

Materials and methods

Patients with partial edentulism and advanced atrophy of the posterior maxillae (≤ 4 mm residual bone height, RBH) underwent MSFA with sole deproteinized bovine bone matrix (DBBM) through a lateral approach. After a 6 to 9-month healing period, bone core biopsies were obtained from the sites of implant insertion for histological evaluation. The correlations between anatomical and histomorphometric variables were analyzed in a multiple regression model.

Results

Forty-nine patients were recruited. One biopsy per patient was obtained from the augmented sinus. Thirty-seven bone core biopsies were intact and met the requirement for histomorphometry analysis. The mean (± standard deviation) percentages of vital bone (VB), remaining DBBM, and non-mineralized tissue were 18.25 ± 4.76%, 27.74 ± 6.68%, and 54.08 ± 6.07%, respectively. No statistically significant correlations were found between RBH and VB% (p = 0.44) or between sinus contour and VB% (p = 0.33). However, there was an inverse correlation between the sinus width (SW) and VB % (SW1: R2 = 0.13, p = 0.03; SW2: R2 = 0.15, p = 0.02).

Conclusions

After a healing period of 6–9 months, wider sinuses augmented with DBBM alone tended to have a lower proportion of new bone formation, while RBH and sinus contour did not appear to affect osteogenesis after MSFA.

Clinical relevance

This study emphasized the effect of anatomy on osteogenesis after MSFA. The result of the study may have an indication to the clinician that SW is a consideration when selecting the bone grafting material and deciding the healing period of MSFA.

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Acknowledgements

The authors would like to thank Dr. Jie Sun, Harvard School of Dental Medicine, for her help in language editing and Marta Pulido, MD, for editorial assistance.

Funding

This study was supported by Science and Technology Ministry (Grant/Award Number 2017YGB1302904); Ninth People's Hospital affiliated to Shanghai Jiao Tong University, School of Medicine "Multi-Disciplinary Team" Clinical Research Project (Grant/Award Number: 2017-1-005); and Basic Research Booster Program (Grant/Award Number JYZZ079).

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Authors and Affiliations

  1. Department of Second Dental Center, Ninth People’s Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai Key Laboratory of Stomatology, National Clinical Research Center of Stomatology, 280 Mohe Road, Shanghai, 201999, China

    Wenjie Zhou, Marko Magic, Minjie Zhuang & Yiqun Wu

  2. Department of Oral Implantology, Ninth People’s Hospital Affiliated with Shanghai Jiao Tong University, School of Medicine, Shanghai Key Laboratory of Stomatology, National Clinical Research Center of Stomatology, 639 Zhizaoju Road, Shanghai, 200011, China

    Feng Wang

  3. School of Dental Medicine, University of Belgrade, Belgrade, Serbia

    Marko Magic

  4. Department of Oral Maxillofacial-Head Neck Oncology, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, National Clinical Research Center of Stomatology, 639 Zhizaoju Road, Shanghai, 200011, China

    Jian Sun

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  1. Wenjie Zhou
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Corresponding author

Correspondence to Yiqun Wu.

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Ethical approval

The protocol was approved by the Institutional Review Board of Shanghai Ninth People's Hospital, China (No: SH9H-2020-T33-2 and 01578). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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The authors declare no competing interests.

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Zhou, W., Wang, F., Magic, M. et al. The effect of anatomy on osteogenesis after maxillary sinus floor augmentation: a radiographic and histological analysis. Clin Oral Invest 25, 5197–5204 (2021). https://doi.org/10.1007/s00784-021-03827-6

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  • DOI: https://doi.org/10.1007/s00784-021-03827-6

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