Simultaneous sinus augmentation with implant placement: histomorphometric comparison of two different grafting materials. A multicenter double-blind prospective randomized controlled clinical trial

Int J Oral Maxillofac Implants. 2013 Mar-Apr;28(2):543-9. doi: 10.11607/jomi.2647.


Purpose: Sinus elevation via the lateral approach for implant rehabilitation of atrophic posterior maxillae is considered a safe and predictable therapy. Several xenogeneic biomaterials of different biologic origin have been used as valid and predictable alternatives to autogenous bone. This multicenter randomized controlled double-blind prospective clinical trial aimed to compare histomorphometrically two xenogeneic grafting materials used for sinus elevation with simultaneous implant placement.

Materials and methods: Seven private practices in Italy were involved. Patients presenting at least one site with a residual bone crest height between 2 and 4 mm were treated. Control sites were grafted with 100% deproteinated particulated bovine bone (DPBB), while test sites were grafted with prehydrated corticocancellous porcine bone (PCPB). Root-form implants were placed simultaneously. Insertion torque and clinical stability were assessed and recorded. At 6 months, a biopsy specimen was harvested from each site, and histomorphometric analyses were performed.

Results: Thirty-seven patients received 42 sinus elevations (24 test and 18 control). Eighty-two implants with adequate primary stability were placed. Fifty-five implants were placed in residual bone crests greater than 2 mm but less than 4 mm (average 2.7 mm) and achieved an average insertion torque of 22.8 ± 11.3 N/cm. Nineteen implants were placed in ridges greater than 3 mm but less than 5 mm, and eight were placed in ridges with more than 5 mm remaining. After 6 months, three implants had failed to integrate, leading to a survival rate of 96.34%. Forty-two specimens were analyzed histomorphometrically. No significant differences in total bone volume (PCPB 37.43%, DPBB 37.52%) or residual grafting material (PCPB 13.55%, DPBB 16.44%) were detected.

Conclusions: In this study, PCPB compared well with DPBB as a grafting material for lateral sinus elevation.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Alveolar Bone Loss / pathology
  • Alveolar Bone Loss / rehabilitation*
  • Animals
  • Biocompatible Materials / therapeutic use*
  • Bone Substitutes / therapeutic use*
  • Cattle
  • Dental Implantation, Endosseous / methods*
  • Dental Implants
  • Dental Restoration Failure / statistics & numerical data
  • Double-Blind Method
  • Female
  • Humans
  • Male
  • Maxilla / surgery
  • Maxillary Sinus / surgery
  • Middle Aged
  • Prospective Studies
  • Sinus Floor Augmentation / methods*
  • Swine
  • Torque


  • Biocompatible Materials
  • Bone Substitutes
  • Dental Implants