Absorbable Gelatin Sponge versus Alloplastic Graft Material as Adjuvants in Direct Sinus Lift Procedures-A Comparative Study

The purpose of this study was to evaluate and compare the quantity of new bone formed in the maxillary sinus using Abgel versus β-TCP as adjuvants in maxillary sinus lift procedures using lateral window approach. This randomized clinical study was conducted on 14 patients with 16 sites in Misch's SA-4 category, divided into Group A: Absorbable gelatin sponge was used as graft material and Group B: Alloplast (β tricalcium phosphate) was used as graft material. In the Abgel group, 4 sites were augmented with immediate implant placement, whereas 4 sites were augmented without implants, similar to the β-TCP group. CBCT scans were obtained pre operatively, immediate post operatively and 5 months post operatively to assess the quantity of bone formed and the maintenance of membrane elevation achieved post augmentation; both within the group and between the two groups. The 5 months post treatment bone height was significantly higher than pre-treatment bone height (p<0.05) in both the groups: however the mean increase in bone height using β-TCP was not statistically significant when compared to Abgel group (p>0.05). On comparing the post treatment height in membrane elevation measurements (irrespective of the material used), more height loss was seen in group without implants (3.52 ± 2.59) than group with implants (1.46 ± 1.12) which was statistically significant (p<0.05). In conclusion, Abgel is effective as an adjuvant in both with and without immediate implant placement; however the bone height achieved is better in patients with immediate implant placement.