Sinus Augmentation with Periosteum derived Tissue Engineered Bone

Inroduction: For the reconstruction of bone defects the gold standard is still the autologous bone harvested from the iliac crest, the mandible or the maxilla. Tissue-engineering procedures for hard tissue augmentations of the maxilla offer significant advantages compared with conventional grafts, as there is minimal or no donor site morbidity, limited availability of bone and the necessity of an additional surgical procedure. Periosteum has been demonstrated to have cell populations, which include chondroprogenitor and osteoprogenitor cells, that can be isolated in tissue culture and form both cartilage and bone. Methods: Eight weeks after harvesting and cultuvating the periosteal cells, the tissue-engineered autologous bone was transplanted into the maxillary sinus of the test group. The control group underwent the same procedure except that autologous cancellous bone from the iliac crest was used instead of tissue engineered bone substitute. Results: The loss of augmented material was significantly higher in the group in which the tissue engineered material was applied. Discussion: Our experiences from this pilot study with tissue engineered bone transplants reveal the necessity to limit the indications for tissue engineered bone. Its application is restricted to the sinus augmentation with simultaneous implant insertion at sites providing a sufficient bone bearing. Keywords: tissue engineering, bone, sinus lift, dental implants