On June 1-4, 2014 the AAP organised an international consensus workshop, co-chaired by the Osteology Board members William V. Giannobile and Pamela K. McClain. The workshop was of huge interest to the Osteology Foundation and therefore supported with an educational grant. The proceedings of this workshop are available with free access in a special supplement of the Journal of Periodontology:

Objectives: To examine histologically the characteristics of the residual material obtained during the placement of dental implants in sites where bone regeneration was previously performed by the procedure of maxillary lateral sinus floor lift, comparing the histological characteristics when a xenograft alone (Geitslich Bio-Oss®) was used versus regenerations where a combination of xenograft and allograft (Bio-Oss®+Puros®) was used. Methods: A descriptive cross-sectional study was conducted according to the established rules of research on human subjects and adjusted to the scientific, technical and administrative standards, with the support of the Research and Ethics Committee of the Faculty of Dentistry at the Pontifical Universidad Javeriana (CIEFOUJ). Analysis of 11 cores obtained from sites that were regenerated by a lateral approach for the elevation of the maxillary sinus floor, 4 cores in control group where a xenograft alone (Geitslich Bio-Oss®) was used and 7 cores in group test (Bio-Oss® + Zimmer Puros®), the samples were obtained from 6 to 12 months after the elevation of the maxillary sinus floor. Histological analysis was performed by an expert pathologist who made observations of the core samples using hematoxylin and eosin staining and polarized light to differentiate structure characteristics, further quantitative analysis was conducted with a public domain Java image processing program (imagej) and an statistical analysis was applied with a Wilcoxon (Mann-Whitney) test. Results: After the samples were processed and analyzed, histologically both groups showed graft particles surrounded by new bone, osteoid cells and osteoblasts. There was graft material in intimate contact with new bone and bone apposition lines with active zones. The control group consistently showed a greater presence of mature cortical new formed bone in comparison to the test group, where the observation showed a more disorganized structure with areas of new formed cancellar bone with areas of cortical bone. The quantitative analysis showed an average of 34% of new bone in control group (xenograft) and 27% in the test group (allograft + xenograft), however the statistical test showed a p value= 0.25. Conclusion: The initial argument of the present study was to analyze histologically the behavior and results of sites regenerated by an effective technique and using clinically proven bone substitutes; and comparing the combination (xenograft + allograft) with the novelty that xenograft alone was used as a control group, being that this design was not reported in common scientific databases at the moment that the study was initiated. Both control and test group resulted in bone resorption and new bone formation, there was not a statistically significant difference between the use of xenograft as a single material or in combination with allograft for maxillary sinus floor lift and subsequent placement of dental implants, also there were no differences in primary stability at the time of placement of the implants. However, the sample size calls for further investigations in order to increase the evidence of the comparison proposed in the present study.

Objectives: A loss in height and width of the alveolar process takes place after tooth extraction, and there is consensus on the benefits of post-extractional socket filling. The aim of this study was to compare peri-implant bone loss at implants placed in alveolar sockets filled with particulate allogenous bone graft (DFDBA 300–500µm) and platelet concentrates versus implants placed in native bone. Methods: A retrospective clinical study was performed with 84 patients, in whom 247 implants were placed, 169 of which were in native bone (control group) and 78 in socket-grafted bone (DFDBA 300–500µm) and autogenous platelet concentrates (test group). Peri-implant bone loss was measured by two independent operators at 6 and 12 months after placement. A student’s t-test and ANOVA were used to compare bone loss in test and control groups, and correlation coefficients between the two operators were calculated. Results: The overall mesial and distal peri-implant bone loss was 0.9± 0.7mm and 0.9± 0.8mm, respectively, at 6 months, and 1.0± 0.65mm and 1.1± 0.7 mm at 12 months. In the test group, the bone loss was 0.8 ± 0.8 mm at 6 months and 1.2 ± 0.9 mm at 12 months. In the control group, the bone loss was 1.0 ± 0.75mm at 6 months and 1.02± 0.6 mm at 12 months. There was no statistically significant difference between the two groups or between patients with or without history of periodontitis. However, there was a significant difference between the maxillary and mandibular peri-implant bone loss. Maxillary bone loss was greater than mandibular bone loss by an average of 0.2mm at 6 months and 0.4mm at 12 months. There was also a difference between unitary and total edentations (0.7mm at 6 months, 1.2 mm at 12 months) and partial and total edentations (0.5mm at 6 months, 1.2mm at 12 months). Conclusions: From the results of this study we can conclude that peri-implant bone loss in alveolar sockets filled with allogenous bone graft (DFDBA 300–500µm) and autogenous platelet concentrates are similar to peri-implant bone loss in native bone.