Introduction Improved histological analysis of bone substitutes has advanced maxillary sinus floor augmentation, leading to better clinical outcomes and implant stability. Careful material selection remains crucial for successful sinus lift procedures addressing posterior maxillary atrophy after tooth loss. This article provides a comprehensive review of the most commonly used materials for sinus lift procedures, focusing on their histological features and their impact on clinical results. The goal is to move beyond simply considering bone substitutes as replacement materials and to understand how their distinct properties enable the development of specific treatment approaches. Methods A literature review was conducted using electronic databases, such as PubMed/MEDLINE, Google Scholar, and the Cochrane Library (2018-August 2024). This review included English-language publications on maxillary sinus floor augmentation using various biomaterials. All clinical trials meeting the inclusion criteria were considered. Results This review included seven studies. The evaluated biomaterials demonstrated effectiveness and biocompatibility in maxillary sinus augmentation. Histological analyses revealed excellent osteoconductive properties, including the formation of new bone directly on the biomaterial surface and its integration into the existing bone structure, without evidence of inflammation. Discussion Each biomaterial category presents unique advantages and limitations. Autografts remain the gold standard but are constrained by availability. Allografts and xenografts provide viable alternatives, with xenografts favoring long-term stability and allografts balancing osteoconduction and osteoinduction. Alloplasts, particularly BCP and bioactive glasses, emerge as versatile options due to their tunable properties and biocompatibility. The findings underscore the importance of matching material properties to clinical needs, such as resorption rate and mechanical support. Conclusion A detailed understanding of the distinct properties of each graft material is crucial for selecting the most suitable bone substitute for maxillary sinus augmentation, resulting in improved clinical outcomes and a higher implant success rate.
Sleman et al. (Mon,) studied this question.