Comparison of Two Different Sizes of Deproteinized Bovine Bone Mineral Particles in Lateral Sinus Floor Elevation With Simultaneous Implant Placement: A Radiographic Study

Objectives To investigate the radiographic changes of two different particle sizes of deproteinized bovine bone mineral (DBBM) following lateral sinus floor elevation (LSFE) with simultaneous implant placement. Materials and Methods A total of 104 patients with 128 implants receiving LSFE with simultaneous implant placement were included and divided according to the grafted DBBM: 47 using small particle sizes (0.25-1 mm), 57 using large particle sizes (1-2 mm). Cone beam computed tomography (CBCT) images were taken at three points (T0: before surgery, T1: immediate postoperative, T2: 6-month postoperative). The two-dimensional and three-dimensional augmentation parameters, including apical bone height (ABH), endo-sinus bone gain (ESBG), peri-implant bone height (PBH), marginal bone loss (MBL), and augmented bone volume (AV) were measured. The differences in augmentation parameters between the small and large particle sizes of DBBM were compared. Results AV was 916.76 (657.88-1243.74) mm(3) at T1 and decreased to 823.73 (583.12-1178.79) mm(3) at T2, pointing to a relative volume stability of 89.8%. Although ABH did not significantly differ between the two groups at T1 (p = 0.379) and T2 (p = 0.264), AV, ESBG, and PBH were significantly higher in the large particle group. At the 6-month follow-up, the reduction rates in AV (p < 0.001), ESBG (p = 0.022), and PBH (p = 0.004) were lower in the large particle group. Conclusions The augmentation outcome decreased after LSFE with simultaneous implant placement at the 6-month follow-up. Using the large particle size of DBBM improved the augmentation stability.