Are culture-expanded autogenous bone cells a clinically reliable option for sinus grafting?

Objectives: This prospective clinical study was designed to examine the healing process during the first 12 months after sinus grafting (SG) with autogenous culture-expanded bone cells (ABC) and bovine bone mineral (BBM) histomorphometrically and radiologically.

Material and methods: Twenty-two sinuses of 12 patients (mean age 56.2±9.3 years) were grafted. Four weeks before, SG bone biopsies were obtained with a trephine burr and the bone cells were isolated and expanded. Every sinus was grafted with BBM and ABC. After 6 months, a biopsy was taken from each sinus and implants (n=82) were placed. These were uncovered after another 6 months and fitted with dentures. The percent newly formed bone (NB) and the NB-to-BBM contact area were determined on undecalcified histologic sections. The sinus graft volume was evaluated by dental CT after SG (CT 1), after implant placement (CT 2) and after implant uncovery (CT 3).

Results: Postoperative healing was uneventful. The NB was 17.9±4.6% and the contact area 26.8±13.1%. The graft volume (in mm³) was 2218.4±660.9 at the time of CT 1, 1694±470.4 at the time of CT 2 and 1347.9±376.3 at the time of CT 3 (P<.01). Three implants were lost after uncovery. Reimplantation and prosthodontic rehabilitation were successful throughout.

Conclusions: These results suggest that SG with ABC and BBM in a clinical setting provides a bony implant site which permits implant placement and will tolerate functional loading.