Horizontal Bone Augmentation With Autogenous and Collagenated Xenogeneic Bone Blocks: A Split-Mouth Prospective Clinical, Tomographic, and Histological Pilot Study.

The aim of this study was to compare the clinical, tomographic, and histological performance of collagenated xenogeneic bone blocks (CXBB) in horizontal bone augmentations for implant placement. Five patients with an absence of the 4 upper incisors and an HAC 3 horizontal bone defect, with a remaining of 3 to 5 mm, underwent a bone-grafting procedure with CXBB (test group [TG], n = 5) and autogenous graft (control group [CG], n = 5), with one type of graft used on the right side and other type on the left side. Changes in bone thickness and density (tomographic evaluation), levels of complications (clinically), and distribution pattern between mineralized and nonmineralized tissue (histomorphometrically) were analyzed. Tomographic analysis showed a horizontal bone increase of 4.25 ± 0.78 mm in the TG and 3.08 ± 0.8 mm in the CG between baseline and 8 months postoperatively (P < .05). The horizontal loss between the day of installation of the blocks and 8 months postoperatively was 1.02 ± 0.39 mm for the TG and 1.10 ± 0.71 mm for the CG (P > .05). With regard to bone density, the TG blocks right after installation had 440.2 ± 89.15 HU, and after 8 months, the region reached 730.7 ± 130.98 HU, representing an increase of 29.05%. For the CG blocks, bone density increased from 1052.2 ± 398.35 HU to 1222.5 ± 453.28 HU, representing an increase of 17.03%. The increase in bone density was significantly higher in the TG (P < .05). Clinically, no cases of exposure of the bone blocks and no failure of incorporation were observed. Histomorphometrically, the percentage of mineralized tissue was lower in the TG than in the CG (48.10% ± 2.88% and 53.53% ± 1.05%, respectively), and the opposite was verified for the levels of nonmineralized tissue (52.79% ± 2.88% and 46.47% ± 1.05%, respectively; P < .05). The use of CXBB achieved higher levels of horizontal gain, with lower bone density and lower levels of mineralized tissue when compared with the use of autogenous blocks.

Enxerto ósseo em levantamento de seio maxilar com osso humano fresco congelado / Bone graft in maxillary sinus with fresh frozen allogeneic bone: a case report

A perda dental em maxila posterior promove a reabsorção do tecido ósseo, o que, juntamente com a pneumatização do seio maxilar gera dificuldades para a reabilitação com implantes osseointegrados. O procedimento de enxerto ósseo em seio maxilar tem sido descrito desde a década de 70 com bons resultados; no entanto, faz-se a necessidade de uma segunda área cirúrgica para obtenção de osso autógeno, o que provoca maior desconforto, aumento do tempo cirúrgico e maior grau de morbidade dos pacientes. Este trabalho tem como finalidade apresentar um caso clínico de utilização de osso humano fresco congelado proveniente de banco de tecidos em enxerto ósseo em seio maxilar. Após seis meses, o enxerto se apresentou integrado, denso e foram instalados três implantes no local. A avaliação histológica demonstrou sinais de osso maduro, remodelado e vital, o que demonstrou que pode ser uma alternativa ao osso autógeno.