The effect of anatomy on osteogenesis after maxillary sinus floor augmentation: a radiographic and histological analysis.

Objectives To assess how anatomy and osteogenesis correlated with results of maxillary sinus floor augmentation (MSFA). Materials and methods Patients with partial edentulism and advanced atrophy of the posterior maxillae (≤ 4 mm residual bone height, RBH) underwent MSFA with sole deproteinized bovine bone matrix (DBBM) through a lateral approach. After a 6 to 9-month healing period, bone core biopsies were obtained from the sites of implant insertion for histological evaluation. The correlations between anatomical and histomorphometric variables were analyzed in a multiple regression model. Results Forty-nine patients were recruited. One biopsy per patient was obtained from the augmented sinus. Thirty-seven bone core biopsies were intact and met the requirement for histomorphometry analysis. The mean (± standard deviation) percentages of vital bone (VB), remaining DBBM, and non-mineralized tissue were 18.25 ± 4.76%, 27.74 ± 6.68%, and 54.08 ± 6.07%, respectively. No statistically significant correlations were found between RBH and VB% (p = 0.44) or between sinus contour and VB% (p = 0.33). However, there was an inverse correlation between the sinus width (SW) and VB % (SW1: R2 = 0.13, p = 0.03; SW2: R2 = 0.15, p = 0.02). Conclusions After a healing period of 6-9 months, wider sinuses augmented with DBBM alone tended to have a lower proportion of new bone formation, while RBH and sinus contour did not appear to affect osteogenesis after MSFA. Clinical relevance This study emphasized the effect of anatomy on osteogenesis after MSFA. The result of the study may have an indication to the clinician that SW is a consideration when selecting the bone grafting material and deciding the healing period of MSFA.