Biphasic calcium phosphate tied to higher graft volume stability in lateral window sinus floor elevation

A study was done to assess in a prospective randomised trial two psychogenic bone substitutes—biphasic calcium phosphate (BCP) versus almost pure hydroxyapatite (HA)—for their volume stability and clinical implications after sinus floor elevation (SFE). Twenty patients requiring lateral-window sinus floor elevation 6 months before implant surgery were randomized to a biphasic calcium phosphate or hydroxyapatite group. As the primary outcome, the grafts were analyzed for volume stability, using four cone-beam computed tomography scans obtained immediately/6/12/24 months after sinus floor elevation. Secondary outcomes were implant survival, success, periotest values, oral-health-related quality of life (OHIP-G14), and pain (VAS).Results: Kolmogorov–Smirnov goodness-of-fit test revealed normal distribution of samples (p = .200). At 6/12/24 months, the augmented volumes decreased to 96/92/90% (HA) or 99/96/96% (biphasic calcium phosphate). Volume changes were significantly a factor of time and reached significantly lower values in the hydroxyapatite group. The significant intergroup difference in volume losses was notable at 24 months (p = .021; t-test for independent samples). Periotest values decreased from −3/−4.1 (HA/BCP) after implant placement to −6.3/−4.5 (HA/BCP) after 6 months. OHIP scores diverged at 2 months and largely resolved by 24 months. VAS scores were comparable, 2.2 at 1 week after sinus floor elevation being their highest mean level. After 2 years, both groups experienced no biological or technical complications, demonstrating a consistent healing trajectory without notable symptoms. Although no significant differences were observed in implant stability and survival, biphasic calcium phosphate demonstrated higher volume stability than hydroxyapatite.

Reference: Sokolowski, A., Theisen, K., Arefnia, B., Payer, M., Lorenzoni, M., & Sokolowski, A. (2023). A randomized clinical trial of phycogenic materials for sinus grafting with hydroxyapatite versus biphasic calcium phosphate: 2 years clinical outcomes. Clinical Oral Implants Research, 00, 1–12. https://doi.org/10.1111/clr.14209