**The Use of Autogenous Bone Mixed with a Biphasic Calcium Phosphate in a Maxillary Sinus Floor Elevation Procedure with a 6-Month Healing Time: A Clinical, Radiological, Histological and Histomorphometric Evaluation**

**Wilhelmus F. Bouwman 1,2, Nathalie Bravenboer 3, Christiaan M. ten Bruggenkate 1,4 and Engelbert A. J. M. Schulten 1,\***


Received: 8 April 2020; Accepted: 6 May 2020; Published: 9 May 2020

**Abstract:** Background: In this study it is evaluated whether autogenous bone mixed with biphasic calcium phosphate (BCP) used in a maxillary sinus floor elevation (MSFE) leads to improved bone formation. Materials and methods: In five patients a unilateral MSFE was performed. Histological and histomorphometric analyses were performed on bone biopsies that were obtained 6 months after MSFE during dental implant surgery. Results: The average vital bone volume was 29.9% of the total biopsy (BV/TV, SD ± 10.1) of which 7.1% was osteoid (OV/BV, SD ± 4.8). The osteoid surface (OS/BS) covered 26.0% (SD <sup>±</sup> 13.4) of the bone surface. The BS/TV covered 4.7 mm2/mm<sup>3</sup> (SD <sup>±</sup> 2.3). Compared with previous studies the analyses showed a difference for trabecular thickness (Tb.Th.) and osteoid surface (OS/BS), but not for BV/TV, OV/BV and the number of osteoclasts. Conclusion: MSFE with autogenous bone mixed with BCP shows an amount of newly formed bone that is comparable with the findings from the previously published 6-month study with pure BCP. However, a better distribution of the new bone over the entire biopsy was observed.

**Keywords:** bone substitute; sinus floor augmentation; maxillary tuberosity
