{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T22:10:42Z","timestamp":1775513442201,"version":"3.50.1"},"reference-count":53,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,1,31]],"date-time":"2023-01-31T00:00:00Z","timestamp":1675123200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Astra Tech","award":["D-2012-024"],"award-info":[{"award-number":["D-2012-024"]}]},{"name":"Astra Tech","award":["UIDB\/00127\/2020"],"award-info":[{"award-number":["UIDB\/00127\/2020"]}]},{"name":"Portuguese Foundation for Science and Technology","award":["D-2012-024"],"award-info":[{"award-number":["D-2012-024"]}]},{"name":"Portuguese Foundation for Science and Technology","award":["UIDB\/00127\/2020"],"award-info":[{"award-number":["UIDB\/00127\/2020"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Materials"],"abstract":"<jats:p>The objective of this study was to compare marginal bone loss, surgical and clinical complications, and dental implant survival rate in bilateral maxillary sinus augmented by autologous or porcine xenograft. A randomized controlled clinical trial using split-mouth design enrolled 12 consent adult patients (59.7 \u00b1 8.7 years), who received bilateral maxillary sinus floor augmentation for oral rehabilitation with implant-supported prosthesis. Each patient received both the autologous bone from the mandible (control) or porcine xenograft (test) during the random bilateral sinus lift surgery. A total of 39 dental implants were placed in the posterior maxilla of the 12 patients after 6 months, being rehabilitated after the respective osseointegration period. Both graft materials demonstrated a high implant survival rate at 12 months: 95% for the xenograft side, only 1 implant without osseointegration, and 100% for the autologous side. Radiographic bone loss was low and similar for both groups: control group with a mean of 0.063 \u00b1 0.126, and test group with a mean of 0.092 \u00b1 0.163. No major surgical-related complications have occurred. Only one patient had several prosthetic complications due to fractures of prosthetic components. The maxillary sinus augmentation procedure, both with autologous bone and porcine xenograft materials, is an excellent clinical option procedure for the prosthetic rehabilitation of atrophic maxillae, with low marginal bone loss after one year follow-up, few clinical complications, and a high implant survival rate.<\/jats:p>","DOI":"10.3390\/ma16031220","type":"journal-article","created":{"date-parts":[[2023,2,1]],"date-time":"2023-02-01T01:36:59Z","timestamp":1675215419000},"page":"1220","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["A Randomized Clinical Trial Comparing Implants Placed in Two Different Biomaterials Used for Maxillary Sinus Augmentation"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8215-4657","authenticated-orcid":false,"given":"Francisco","family":"Correia","sequence":"first","affiliation":[{"name":"Department of Oral Surgery and Periodontology, Faculty of Dental Medicine, University of Porto, 4200-393 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0375-7610","authenticated-orcid":false,"given":"S\u00f3nia Alexandre","family":"Gouveia","sequence":"additional","affiliation":[{"name":"Intelligent Systems Associate Laboratory (LASI), Department of Electronics, Telecommunications and Informatics (DETI), Institute of Electronics and Informatics Engineering of Aveiro (IEETA), University of Aveiro, 3810-193 Aveiro, Portugal"}]},{"given":"Daniel Humberto","family":"Pozza","sequence":"additional","affiliation":[{"name":"Department of Biomedicine, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"},{"name":"Department of Histology, Faculty of Nutrition and Food Sciences, University of Porto, 4150-177 Porto, Portugal"},{"name":"Institute for Research and Innovation in Health and IBMC, University of Porto, 4200-135 Porto, Portugal"}]},{"given":"Ant\u00f3nio Campos","family":"Felino","sequence":"additional","affiliation":[{"name":"Department of Oral Surgery and Periodontology, Faculty of Dental Medicine, University of Porto, 4200-393 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9265-0913","authenticated-orcid":false,"given":"Ricardo","family":"Faria-Almeida","sequence":"additional","affiliation":[{"name":"Department of Oral Surgery and Periodontology, Faculty of Dental Medicine, University of Porto, 4200-393 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1902\/jop.2007.060048","article-title":"Bone augmentation techniques","volume":"78","author":"McAllister","year":"2007","journal-title":"J. Periodontol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1111\/clr.12674","article-title":"Therapeutic concepts and methods for improving dental implant outcomes. Summary and consensus statements. The 4th EAO Consensus Conference 2015","volume":"26","author":"Sanz","year":"2015","journal-title":"Clin. Oral Implants Res."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1106","DOI":"10.1016\/j.bjoms.2016.08.003","article-title":"Schneider membrane thickness classification evaluated by cone-beam computed tomography and its importance in the predictability of perforation. Retrospective analysis of 200 patients","volume":"54","author":"Rapani","year":"2016","journal-title":"Br. J. Oral Maxillofac. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"680","DOI":"10.1563\/AAID-JOI-D-10-00122","article-title":"Prevalence of sinus augmentation associated with maxillary posterior implants","volume":"39","author":"Seong","year":"2013","journal-title":"J. Oral Implantol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e85","DOI":"10.11607\/prd.4497","article-title":"Minimally Invasive Management of Implant-Supported Rehabilitation in the Posterior Maxilla, Part, I. Sinus Floor Elevation: Biologic Principles and Materials","volume":"40","author":"Stacchi","year":"2020","journal-title":"Int. J. Periodontics Restor. Dent."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1563\/aaid-joi-D-19-00288","article-title":"Osseodensified Crestal Sinus Window Augmentation: An Alternative Procedure to the Lateral Window Technique","volume":"47","author":"Salgar","year":"2021","journal-title":"J. Oral Implantol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e86","DOI":"10.1590\/1807-3107bor-2018.vol32.0086","article-title":"Short implants versus longer implants with maxillary sinus lift. A systematic review and meta-analysis","volume":"32","author":"Cruz","year":"2018","journal-title":"Braz. Oral Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1111\/ors.12649","article-title":"Lateral window technique: A focus review","volume":"15","author":"Correia","year":"2021","journal-title":"Oral Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1111\/jopr.12317","article-title":"Analysis of Bone Height Changes after Maxillary Sinus Augmentation with Simultaneous and Delayed Placement of Dental Implants: A Clinical and Radiographic Study","volume":"25","author":"Yin","year":"2016","journal-title":"J. Prosthodont."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1034\/j.1600-0501.2000.011003256.x","article-title":"Anatomical aspects of sinus floor elevations","volume":"11","author":"Disch","year":"2000","journal-title":"Clin. Oral Implant. Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1097\/ID.0000000000000001","article-title":"Comparison of piezosurgery and conventional rotative instruments in direct sinus lifting","volume":"22","author":"Delilbasi","year":"2013","journal-title":"Implant. Dent."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1106","DOI":"10.1111\/clr.12702","article-title":"Histomorphometric outcomes after lateral sinus floor elevation procedure: A systematic review of the literature and meta-analysis","volume":"27","author":"Corbella","year":"2016","journal-title":"Clin. Oral Implant. Res."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1111\/cid.12964","article-title":"Maxillary sinus augmentation with three different biomaterials: Histological, histomorphometric, clinical, and patient-reported outcomes from a randomized controlled trial","volume":"23","author":"Valente","year":"2021","journal-title":"Clin. Implant. Dent. Relat. Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1111\/clr.13098","article-title":"Histopathological comparison of healing after maxillary sinus augmentation using xenograft mixed with autogenous bone versus allograft mixed with autogenous bone","volume":"29","year":"2018","journal-title":"Clin. Oral Implant. Res."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"188","DOI":"10.11607\/jomi.4752","article-title":"Histomorphometric Evaluation of Two Different Bone Substitutes in Sinus Augmentation Procedures: A Randomized Controlled Trial in Humans","volume":"32","author":"Baena","year":"2017","journal-title":"Int. J. Oral Maxillofac. Implant."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"812","DOI":"10.1111\/cid.12518","article-title":"Comparison between mineralized cancellous bone allograft and an alloplast material for sinus augmentation: A split mouth histomorphometric study","volume":"19","author":"Kolerman","year":"2017","journal-title":"Clin. Implant Dent. Relat. Res."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"121","DOI":"10.11607\/jomi.4801","article-title":"Cellular, Vascular, and Histomorphometric Outcomes of Solvent-Dehydrated vs Freeze-Dried Allogeneic Graft for Maxillary Sinus Augmentation: A Randomized Case Series","volume":"32","author":"Monje","year":"2017","journal-title":"Int. J. Oral Maxillofac. Implant."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1111\/cid.12561","article-title":"The applications of regenerative medicine in sinus lift procedures: A systematic review","volume":"20","author":"Correia","year":"2018","journal-title":"Clin. Implant. Dent. Relat. Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1111\/clr.12615","article-title":"EAO Supplement Working Group 4\u2014EAO CC 2015 Short implants versus sinus lifting with longer implants to restore the posterior maxilla: A systematic review","volume":"26","author":"Thoma","year":"2015","journal-title":"Clin. Oral Implant. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"882","DOI":"10.1111\/cid.12660","article-title":"Does intraoperative perforation of Schneiderian membrane during sinus lift surgery causes an increased the risk of implants failure?: A systematic review and meta regression analysis","volume":"20","author":"Elsharkawy","year":"2018","journal-title":"Clin. Implant Dent. Relat. Res."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e1000251","DOI":"10.1136\/bmj.c332","article-title":"CONSORT 2010 Statement: Updated guidelines for reporting parallel group randomised trials","volume":"340","author":"Schulz","year":"2010","journal-title":"BMJ"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Correia, F., Pozza, D.H., Gouveia, S., Felino, A.C., and Faria-Almeida, R. (2021). Advantages of Porcine Xenograft over Autograft in Sinus Lift: A Randomised Clinical Trial. Materials, 14.","DOI":"10.3390\/ma14123439"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"543","DOI":"10.11607\/jomi.2647","article-title":"Simultaneous sinus augmentation with implant placement: Histomorphometric comparison of two different grafting materials. A multicenter double-blind prospective randomized controlled clinical trial","volume":"28","author":"Silvestri","year":"2013","journal-title":"Int. J. Oral Maxillofac. Implant."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"746","DOI":"10.1111\/j.1708-8208.2010.00314.x","article-title":"A collagenated porcine bone substitute for augmentation at Neoss implant sites: A prospective 1-year multicenter case series study with histology","volume":"14","author":"Pagliani","year":"2012","journal-title":"Clin. Implant Dent. Relat. Res."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"469","DOI":"10.11607\/prd.2999","article-title":"Interpositional Augmentation Technique in the Treatment of Posterior Mandibular Atrophies: A Retrospective Study Comparing 129 Autogenous and Heterologous Bone Blocks with 2 to 7 Years Follow-Up","volume":"37","author":"Felice","year":"2017","journal-title":"Int. J. Periodontics Restor. Dent."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1038\/s41592-019-0470-3","article-title":"Moving beyond P values: Data analysis with estimation graphics","volume":"16","author":"Ho","year":"2019","journal-title":"Nat. Methods"},{"key":"ref_27","first-page":"257","article-title":"Short implants versus bone augmentation for placing longer implants in atrophic maxillae: One-year post-loading results of a pilot randomised controlled trial","volume":"8","author":"Esposito","year":"2015","journal-title":"Eur. J. Oral Implantol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1097\/ID.0000000000000411","article-title":"Incidence, Risk Factors, and Complications of Schneiderian Membrane Perforation in Sinus Lift Surgery: A Meta-Analysis","volume":"25","year":"2016","journal-title":"Implant Dent."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1016\/j.bjoms.2016.05.008","article-title":"A comprehensive clinical review of maxillary sinus floor elevation: Anatomy, techniques, biomaterials and complications","volume":"54","author":"Loomer","year":"2016","journal-title":"Br. J. Oral Maxillofac. Surg."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1097\/ID.0000000000000768","article-title":"Maxillary Sinus Floor Augmentation With Synthetic Bone Substitutes Compared With Other Grafting Materials: A Systematic Review and Meta-analysis","volume":"27","author":"Mordenfeld","year":"2018","journal-title":"Implant Dent"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1186\/s13005-022-00339-w","article-title":"Removal of dental implants displaced into the maxillary sinus: A retrospective single-center study","volume":"18","author":"Bennardo","year":"2022","journal-title":"Head Face Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1016\/j.bjoms.2015.02.012","article-title":"Grafting after sinus lift with anorganic bovine bone alone compared with 50:50 anorganic bovine bone and autologous bone: Results of a pilot randomised trial at one year","volume":"53","author":"Meloni","year":"2015","journal-title":"Br. J. Oral Maxillofac. Surg."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1007\/s12663-014-0643-7","article-title":"Comparative study of alveolar bone height and implant survival rate between autogenous bone mixed with platelet rich plasma versus venous blood for maxillary sinus lift augmentation procedure","volume":"14","author":"Kumar","year":"2015","journal-title":"J. Maxillofac. Oral Surg."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Velasco-Ortega, E., Sierra-Baztan, A., Jimenez-Guerra, A., Espana-Lopez, A., Ortiz-Garcia, I., Nunez-Marquez, E., Moreno-Munoz, J., Rondon-Romero, J.L., Lopez-Lopez, J., and Monsalve-Guil, L. (2021). Long-Term Clinical Study of Implants Placed in Maxillary Sinus Floor Augmentation Using Beta-Tricalcium Phosphate. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18199975"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1016\/j.ijom.2013.09.006","article-title":"Maxillary sinus floor elevation surgery with BioOss(R) mixed with a bone marrow concentrate or autogenous bone: Test of principle on implant survival and clinical performance","volume":"43","author":"Rickert","year":"2014","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1111\/prd.12408","article-title":"Etiology, occurrence, and consequences of implant loss","volume":"88","author":"Tomasi","year":"2022","journal-title":"Periodontol. 2000"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1111\/clr.12684","article-title":"A systematic review of implant outcomes in treated periodontitis patients","volume":"27","author":"Sousa","year":"2016","journal-title":"Clin. Oral Implant. Res."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e62","DOI":"10.1111\/clr.12333","article-title":"Smoking and the risk of peri-implantitis. A systematic review and meta-analysis","volume":"26","author":"Sgolastra","year":"2015","journal-title":"Clin. Oral Implant. Res."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1775","DOI":"10.1902\/jop.2013.120608","article-title":"Implant survival and marginal bone loss at turned and oxidized implants in periodontitis-susceptible smokers and never-smokers: A retrospective, clinical, radiographic case-control study","volume":"84","author":"Sayardoust","year":"2013","journal-title":"J. Periodontol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1586","DOI":"10.1902\/jop.2012.120592","article-title":"The frequency of peri-implant diseases: A systematic review and meta-analysis","volume":"84","author":"Atieh","year":"2013","journal-title":"J. Periodontol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"927","DOI":"10.11607\/jomi.3732","article-title":"Survival Rate of Dental Implants in Patients with History of Periodontal Disease: A Retrospective Cohort Study","volume":"32","author":"Correia","year":"2017","journal-title":"Int. J. Oral Maxillofac. Implant."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Stacchi, C., Troiano, G., Montaruli, G., Mozzati, M., Lamazza, L., Antonelli, A., Giudice, A., and Lombardi, T. (2022). Changes in implant stability using different site preparation techniques: Osseodensification drills versus piezoelectric surgery. A multi-center prospective randomized controlled clinical trial. Clin. Implant Dent. Relat. Res., online ahead of print.","DOI":"10.1111\/cid.13140"},{"key":"ref_43","first-page":"1151","article-title":"A 3-year clinical follow-up of implants placed in two different biomaterials used for sinus augmentation","volume":"27","author":"Lindgren","year":"2012","journal-title":"Int. J. Oral Maxillofac. Implant."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1111\/jcpe.12694","article-title":"Short dental implants (6 mm) versus long dental implants (11\u201315 mm) in combination with sinus floor elevation procedures: 3-year results from a multicentre, randomized, controlled clinical trial","volume":"44","author":"Pohl","year":"2017","journal-title":"J. Clin. Periodontol."},{"key":"ref_45","first-page":"65","article-title":"1-stage versus 2-stage lateral sinus lift procedures: 1-year post-loading results of a multicentre randomised controlled trial","volume":"7","author":"Felice","year":"2014","journal-title":"Eur. J. Oral Implantol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"926","DOI":"10.1111\/cid.12374","article-title":"Sinus Floor Augmentation Using Straumann(R) BoneCeramic and Bio-Oss(R) in a Split Mouth Design and Later Placement of Implants: A 5-Year Report from a Longitudinal Study","volume":"18","author":"Mordenfeld","year":"2016","journal-title":"Clin. Implant Dent. Relat. Res."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1111\/clr.13912","article-title":"Maxillary sinus floor augmentation comparing bovine versus porcine bone xenografts mixed with autogenous bone graft. A split-mouth randomized controlled trial","volume":"33","author":"Zurita","year":"2022","journal-title":"Clin. Oral Implant. Res."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1097\/ID.0000000000000717","article-title":"Patient-Reported Outcomes After Lateral Wall Sinus Floor Elevation: A Systematic Review","volume":"27","author":"Younes","year":"2018","journal-title":"Implant Dent."},{"key":"ref_49","first-page":"425","article-title":"Sinus lift grafting with anorganic bovine bone vs 50% autologous bone mixed with 50% anorganic bovine bone: 2 years after loading results from a randomised controlled trial","volume":"10","author":"Meloni","year":"2017","journal-title":"Eur. J. Oral Implantol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1111\/joor.12431","article-title":"Bruxism and dental implant failures: A multilevel mixed effects parametric survival analysis approach","volume":"43","author":"Chrcanovic","year":"2016","journal-title":"J. Oral Rehabil."},{"key":"ref_51","first-page":"393","article-title":"Four mm-long versus longer implants in augmented bone in atrophic posterior jaws: 4-month post-loading results from a multicentre randomised controlled trial","volume":"9","author":"Esposito","year":"2016","journal-title":"Eur. J. Oral Implantol."},{"key":"ref_52","first-page":"129","article-title":"Cosci versus Summers technique for crestal sinus lift: 3-year results from a randomised controlled trial","volume":"7","author":"Esposito","year":"2014","journal-title":"Eur. J. Oral Implantol."},{"key":"ref_53","first-page":"297","article-title":"Sinus lift with guided bone regeneration or anorganic bovine bone: 1-year post-loading results of a pilot randomised clinical trial","volume":"3","author":"Esposito","year":"2010","journal-title":"Eur. J. Oral Implantol."}],"container-title":["Materials"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1996-1944\/16\/3\/1220\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:19:46Z","timestamp":1760120386000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1996-1944\/16\/3\/1220"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,31]]},"references-count":53,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,2]]}},"alternative-id":["ma16031220"],"URL":"https:\/\/doi.org\/10.3390\/ma16031220","relation":{},"ISSN":["1996-1944"],"issn-type":[{"value":"1996-1944","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,31]]}}}