The use of cortical heterologous sheets for sinus lift bone grafting: a modification of Tulasne's technique with 7-year follow-up.

In this article, the authors describe their experience with using cortical deantigenated equine bone sheets in sinus lift grafting procedures performed on 23 patients. The technique employed resembles that described by Tulasne but avoids the need for using harvested calvaria bone and introduces some additional operating variants. The use of heterologous cortical bone sheets effectively managed even large lacerations of the Schneiderian membrane and allowed for immediate stabilization of the heterologous bone granules. Average histomorphometric values for bone cores collected six months after grafting, at the time of implant placement, were: newly formed bone tissue, residual bone substitute, medullary spaces. At seven year follow-up, clinical and radiographic examination indicated that the use of the bone sheets preserved the regenerated bone volume. In conclusion, the use of heterologous cortical bone sheets in association with granular bone graft material enabled long-term stabilization of the graft material and effective management of intra-surgical complications.

Maxillary sinus lift through heterologous bone grafts and simultaneous acid-etched implants placement. Five year follow-up.

AIM: The aim of this study was to assess retrospectively at 5 years the clinical outcome of bone regeneration in patients who underwent maxillary sinus lift with different equine-derived, enzyme-deantigenated equine bone grafts, and simultaneous placement of acid-etched surface implants. METHODS: Eighteen patients (10 males and 8 females, age between 55 and 61 years) were considered. They were divided into 2 groups according to the type of bone graft used: a combination of an equine flexible heterologous spongy bone layer (Osteoplant Flex, Bioteck) and equine heterologous cortical and spongy granules (Bio-Gen Mix, Bioteck), group A, or a block of equine heterologous spongy bone (Bio-Gen Block, Bioteck), group B. Surface-treated implants (''TRE'' type, Biotec) were placed simultaneously to sinus augmentations and usual clinical and radiological tests were performed at 6 months and every year up to 5 years after surgery. RESULTS: At 5 years, 45 out of 49 total implants placed (91.8%) were successful according to the Albrektsson and Zarb criteria. The loss of the 4 failed implants was observed in 2 patients of group B during the first days following surgery. CONCLUSION: These results show that the heterologous bone grafts supported properly the bone regeneration inside the sinuses, and that the type of implants used allowed to achieve a satisfying rate of success according to the current standards in implantology.