A Comparative Histomorphometric Analysis of Two Biomaterials for Maxillary Sinus Augmentation: A Randomized Clinical, Crossover, and Split-Mouth Study

INTRODUCTION: Considering oral rehabilitation with dental implants, many studies have aimed at improving bone regeneration through the use of biomaterials. OBJECTIVE: This study aimed at comparing bone neoformation in patients undergoing bilateral maxillary sinus surgery with two bovine biomaterials. MATERIALS AND METHODS: This is a randomized, blinded, clinical crossover, and divided mouth study. Ten participants with an indication of maxillary sinus enlargement were selected and underwent surgical treatment with Bio-Oss® graft biomaterial (graft 1) on one side and Lumina-Porous® graft biomaterial (graft 2) on the other. The samples were collected after nine months and fixed and then decalcified in 10% ethylenediamine tetra-acetic acid (EDTA) solution for 30 days to process and make histological slides. Connective and bone tissue were further analyzed to identify the amount of newly formed bone. RESULTS: The graft 1 group had a greater formation of vital mineralized tissue when compared to the graft 2 group (p = 0.01). For nonvital mineralized tissue and amount of connective tissue, there was no statistical difference (p = 0.21 and p = 0.09, respectively). The medullary spaces were larger in the graft 2 group. The group treated with graft 1 presented a higher percentage of osteoclasts and viable osteocytes compared to the graft 2 group (p = 0.014 and p = 0.027, respectively). CONCLUSION: Every day, new alternative biomaterials are offered as an option in oral rehabilitation. In this study, both treatments induced bone neoformation after 9 months; however, the group treated with Bio-Oss® showed a higher percentage of vital mineralized bone tissue.