Bovine-HA spongiosa blocks and immediate implant placement in sinus augmentation procedures: Histopathological and histomorphometric observations on different histological stainings in 10 consecutive patients

Bovine mineral spongiosa block (B-SB) was used as a bone substitute in sinus augmentation procedures in 10 consecutive patients. Implants were placed during the same session. The purpose of this study was to histopathologically examine the healing of the grafted site around the implants at 12 months. Radiographic follow-up showed apparent bone apposition in the augmented area around the implants. Clinically, all 36 implants were stable and integrated with the surrounding tissue. Histopathologically, new bone formation was evident in all specimen hard tissue cores. Hydroxyapatite particles were present in direct contact with the remodeled osseous tissue. Mallory trichrome staining showed different stages of mineralization and maturation of the newly formed bone around the grafted mineral particles. Morphometric evaluation of Picrosirius red stained slides under polarized light microscopy was performed at the peripheral/external and deep section slides of all specimens. The average bone area fraction was 34.2%, with a 1:5.4 mean lamellar/woven bone ratio at the peripheral side and 53.0%, with 1:2.5 mean ratio at the deep side. The differences of both parameters between the two sites were statistically significant. B-SB proved to be a suitable grafting material with simultaneously placed implants in sinus floor augmentation procedures.