Monophasic ß‐TCP vs. biphasic HA/ß‐TCP in two‐stage sinus floor augmentation procedures – a prospective randomized clinical trial. Issue 10 (29th September 2016)

• Record Type: Journal Article
• Authors: Jelusic, Damir; Zirk, Matthias L.; Fienitz, Tim; Plancak, Darije; Puhar, Ivan; Rothamel, Daniel
• Is Part Of: Clinical oral implants research. Volume 28:Issue 10(2017)
• Page Start: e175
• Page End: e183
• Publication Date: 2016-09-29
• Subjects: augmentation -- biphasic -- bone substitute -- hydroxyapatite -- implantology -- sinus lift -- β‐tricalcium phosphate; Dental implants -- Research -- Periodicals; 617.69
• DOI: 10.1111/clr.12983
• Languages: English
• ISSNs: 0905-7161

Abstract

Abstract: Objectives: To compare a monophasic (100% ß‐TCP) and a biphasic (60% HA and 40% ß‐TCP) bone substitute material (BSM) regarding biocompatibility, osteoconductivity and implant stability using histological, radiological and resonance frequency analysis. Material and Methods: Sixty‐seven sinus floor elevations were performed in 60 patients. One patient group (monophasic bone substitute [MBS], 30 patients, 32 sinuses) was augmented by the use of the monophasic material (Bioresorb ®, Sybron Implant Solutions, Bremen, Germany), while the second group (biphasic bone substitute (BBS), 30 patients, 35 sinuses) received a biphasic material (Maxresorb ®, Botiss Biomaterials, Berlin, Germany). Cone beam CT images were taken immediately after augmentation and prior to implant placement after 6 months. Trephines were harvested, while the implant bed was prepared. Resonance frequency analysis was performed immediately after implant placement and 6 months later. Descriptive analysis was performed on all augmented sinus ( n = 67). For statistical comparison of the groups, one sinus of each bilaterally treated patient was randomly excluded, resulting in 30 sinuses grafted with MBS and 30 sinuses grafted with BBS ( n = 60). Results: Histomorphometrical analysis of all sinuses displayed comparable results for both groups regarding new bone matrix (MBS 36.16 ± 19.37%, BBS 38.42 ± 12.61%), residual BSM (MBS 30.26 ± 11.7%, BBS 32.66 ± 12.57%) and non‐mineralized tissue (MBS 34.29 ± 18.32%, BBS 28.92 ± 15.04) %) ( P > 0.05, respectively). Radiological volume of BBS was significantly more stable (volume loss of 22.2% for MBS, 6.66% for BBS; P < 0.001), and homogeneity of the graft after 6 months was higher for BBS than that for MBS ( P < 0.05). Resonance frequency analysis endorsed a higher implant stability quotient for BBS after 6 months than that for MBS (MBS 78.31 ± 5.81, BBS 80.42 ± 6.31; P < 0.05, Mann–Whitney U ‐test, respectively). Conclusion: Both monophasic and biphasic materials show good biocompatibility and osteoconductivity with satisfactory support on implant stability. BBS remains more stable in terms of volume maintenance and radiological graft homogeneity after a healing period of 6 months.