Bone formation in sinus augmentation with different xenograft particle sizes: systematic review and meta-analysis

GENARI, Bruna; CANTARELLI, Romulo; RAMOS NETO, Antonio da Silva; SILVA, Emílio Barbosa e; DEGRAZIA, Felipe Weidenbach

doi:10.1590/1981-86372022006020210006

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RGO - Revista Gaúcha de Odontologia

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REVIEW • Rev Gaúch. Odontol. 70 • 2022 • https://doi.org/10.1590/1981-86372022006020210006 copy

Bone formation in sinus augmentation with different xenograft particle sizes: systematic review and meta-analysis

Formação óssea em levantamento de seio maxilar com diferentes tamanhos de partículas de enxerto xenográfico: revisão sistemática e meta-análise

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

The commercial bovine bone mineral most commonly used is available in two particle sizes and studies have demonstrated contradictory results regarding bone formation volume using small or large particles. The aim of this systematic review and meta-analysis was to compare the bone formation volume and residual bovine bone volume in sinus floor augmentation using small and large particles. The following outcome measures were assessed: bone formation volume (%) and residual bovine bone particles volume (%) assessed by histomorphometric analysis. The initial screening resulted in 236 records. After removal of duplicated articles and analysis of titles, abstracts and full texts, three articles were included in the meta-analysis. The bone formation volume and residual bovine bone volume did not differ between small and large particles, with low heterogeneity of studies. The particle size of bovine bone mineral did not influence bone formation percentage; small and large particles of bovine bone graft presented similar residual bone mineral; more randomized clinical trials should be performed to completely confirm that bovine bone mineral particle size does not affect the result of sinus floor augmentation.

Indexing terms
Dental caries; Dental atraumatic restorative treatment; Pediatric Dentistry; Tooth deciduous

Study ID	Study design	Number of participants	Procedure	Test group	Control group	Follow-up period (months)	Outcomes
Chackartchi et al. [¹¹11 Chackartchi T, Iezzi G, Goldstein M, Klinger A, Soskolne A, Piattelli A, et al. Sinus floor augmentation using large (1–2 mm) or small (0.25–1 mm) bovine bone mineral particles: a prospective, intra-individual controlled clinical, micro-computerized tomography and histomorphometric study. Clin Oral Implants Res. 2011;22(1):473-80. https://doi.org/10.1111/j.1600-0501.2010.02032.x https://doi.org/10.1111/j.1600-0501.2010... ]	randomized clinical trial	10	bilateral sinus floor augmentation	small particles	large particles	6 to 9	morphometric results by micro-CT, histological and histomorphometric outcomes
Testori et al. [¹⁴14 Testori T, Wallace SS, Trisi P, Capelli M, Zuffetti F, Del Fabbro M. Effect of xenograft (ABBM) particle size on vital bone formation following maxillary sinus augmentation: a multicenter, randomized, controlled, clinical histomorphometric trial. Int J Periodontics Restorative Dent. 2013;33(1):467-75. https://doi.org/10.11607/prd.1423 https://doi.org/10.11607/prd.1423... ]	randomized clinical trial	13	bilateral sinus floor augmentation	small particles	large particles	6 a 8	histological and histomorphometric outcomes
de Molon et al. [¹⁵15 de Molon RS, Magalhaes-Tunes FS, Semedo CV, Furlan RG, de Souza LGL, de Souza Faloni AP, et al. A randomized clinical trial evaluating maxillary sinus augmentation with different particle sizes of demineralized bovine bone mineral: histological and immunohistochemical analysis. Int J Oral Maxillofac Surg. 2019;48(7):810-23. https://doi.org/10.1016/j.ijom.2018.09.003 https://doi.org/10.1016/j.ijom.2018.09.0... ]	randomized clinical trial	10	bilateral sinus floor augmentation	small particles	large particles	8	histological and histomorphometric outcomes

Study ID	Groups	Histomorphometric outcomes				Morphometric outcomes by micro-CT
Study ID	Groups	Bone formation (%)	Residual bovine bone mineral (%)	Spaces (%)	Soft tissue/hard tissue rate	Increased bone height (mm)	Volume of bone (%)	Bovine bone mineral (%)	Soft tissue (%)
Chackartchi et al. [¹¹11 Chackartchi T, Iezzi G, Goldstein M, Klinger A, Soskolne A, Piattelli A, et al. Sinus floor augmentation using large (1–2 mm) or small (0.25–1 mm) bovine bone mineral particles: a prospective, intra-individual controlled clinical, micro-computerized tomography and histomorphometric study. Clin Oral Implants Res. 2011;22(1):473-80. https://doi.org/10.1111/j.1600-0501.2010.02032.x https://doi.org/10.1111/j.1600-0501.2010... ]	Small particles	34.6±8.1	28.0±6.5	37.4±4.1	-	-	14.6±12.0	22.9±8.3	62.5±14.9
	Large particles	33.7±8.3	27.1±3.9	39.1±8.5	-	-	8.0±4.2	23.1±6.2	68.9±4.1
Testori et al. [¹⁴14 Testori T, Wallace SS, Trisi P, Capelli M, Zuffetti F, Del Fabbro M. Effect of xenograft (ABBM) particle size on vital bone formation following maxillary sinus augmentation: a multicenter, randomized, controlled, clinical histomorphometric trial. Int J Periodontics Restorative Dent. 2013;33(1):467-75. https://doi.org/10.11607/prd.1423 https://doi.org/10.11607/prd.1423... ]	Small particles	18.8±4.7	21.7±10.5	-	59.6±9.9	-	-	-	-
	Large particles	26.8±9.6	20.0±9.0	-	53.2±11.5	-	-	-	-
de Molon et al. [¹⁵15 de Molon RS, Magalhaes-Tunes FS, Semedo CV, Furlan RG, de Souza LGL, de Souza Faloni AP, et al. A randomized clinical trial evaluating maxillary sinus augmentation with different particle sizes of demineralized bovine bone mineral: histological and immunohistochemical analysis. Int J Oral Maxillofac Surg. 2019;48(7):810-23. https://doi.org/10.1016/j.ijom.2018.09.003 https://doi.org/10.1016/j.ijom.2018.09.0... ]	Small particles	36.1±9.6	32.4±8.6	-	-	7.9±2.1	-	-	-
	Large particles	36.7±5.8	38.0±6.9	-	-	9.2±1.3	-	-	-

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[1] Correspondence to: B GENARI. E-mails: E-mail: bruna.genari@gmail.com.