Comparison of four bone substitute types in sinus augmentation with perforated Schneiderian membrane: An experimental study

Collagenated bovine bone mineral (CBBM) is used for maxillary sinus elevation-based augmentation. We compared collagen degradation in cross-linked (CL) CBBM and non-cross-linked (NCL) CBBM (in vitro) and preclinical results in CBBM-CL, CBBM-NCL, deproteinized bovine bone mineral (DBBM), and DBBM with fibrin sealant (in vivo) after repair of perforated Schneiderian membrane (SM). After bilateral maxillary SM perforation (5 mm) during sinus elevation, we performed bone substitute-based augmentation. At 4 and 12 weeks postoperatively, volumetric, histologic, as well as histomorphometric analyses were performed. Based on this study, CL collagen in CBBM-CL contributes to enhanced graft stability over time. Fibrin glue appeared to have a positive effect on early ossification in histological evaluations, but this effect was not evident at 12 weeks.