A Histomorphometric Comparison of Bio-Oss Alone Versus Bio-Oss and Platelet-Derived Growth Factor for Sinus Augmentation: A Postsurgical Assessment

Stuart J. Froum, DDS/Stephen Wallace, DDS/Sang-Choon Cho, DDS/Edwin Rosenberg, DMD/Scott Froum, DDS/Robert Schoor, DDS/Patrick Mascarenhas, DDS/Dennis P. Tarnow, DDS/Patricia Corby, DDS, MS/Nicolas Elian, DDS/Stefan Fickl, DDS/John Ricci, PhD/Bin Hu, MD/Timothy Bromage, PhD/Ismael Khouly, DDS, MS: The purpose of this study was to assess vital bone formation at 4 to 5 months and 7 to 9 months following sinus augmentation with anorganic bovine bone matrix (ABBM) with and without recombinant human platelet-derived growth factor (rhPDGF). Twenty-four subjects received bilateral sinus elevation surgery with ABBM on one side and ABBM and rhPDGF on the contralateral side. Twelve patients had core sampling at 4 to 5 months and 12 patients at 7 to 9 months postoperatively. In subjects with cores taken at 4 to 5 months, mean vital bone, connective tissue, and residual graft were 11.8%, 54.1%, and 33.6%, respectively, with ABBM alone. Cores of sinuses filled with ABBM and rhPDGF showed mean 21.1% vital bone, 51.4% connective tissue, and 24.8% residual graft. Paired t test showed a statistically significant difference in vital bone. In cores taken at 7 to 9 months, the values for ABBM alone and ABBM + rhPDGF were 21.4% vs 19.5% vital bone, 28.4% vs 44.2% connective tissue, and 40.3% residual graft vs 35.5%. There was no statistically significant difference in vital bone at 7 to 9 months after surgery. Test and control groups showed clinically acceptable levels of vital bone both at 4 to 5 months and 7 to 9 months postsurgery. However, vital bone formation was significantly greater in the 4- to 5-month sections of ABBM + rhPDGF vs the Bio-Oss alone. In the 7- to 9-month specimens, this difference disappeared. More rapid formation of vital bone with the addition of rhPDGF may allow for earlier implant placement. (Int J Periodontics Restorative Dent 2013;33:269–279. doi: 10.11607/prd.1614)