Partially demineralized allogeneic cancellous bone plug versus deproteinized bovine bone mineral for guided bone regeneration: a pilot randomized controlled clinical trial

Clinical Snapshot

Key Findings

• P Value: P=0.105 for vital bone; P=0.006 for residual graft material

• Effect Size: 6.66% difference in vital bone (not statistically significant, P=0.105)

• Primary Outcome: Vital bone percentage at 6 months: ACBP 38.84±8.37% vs DBBM 32.18±11.04%

• Nnt Or Sensitivity: Residual graft material significantly lower with ACBP (11.18±5.48% vs 19.80±8.23%)

• Confidence Interval: Not reported

Clinical Application

Both materials are commercially available; ACBP may offer faster graft turnover but requires specialized processing and storage Both ACBP and DBBM are available in Australia; choice may depend on TGA-approved products, cost considerations, and surgeon preference for graft remodeling characteristics Adult patients requiring guided bone regeneration for posterior maxillary sinus augmentation or mandibular socket preservation

Abstract

OBJECTIVES: To compare a partially demineralized allogeneic cancellous bone plug (ACBP) with deproteinized bovine bone mineral (DBBM) for guided bone regeneration (GBR), focusing on CBCT-based dimensional outcomes and histomorphometric tissue composition at implant placement. MATERIALS AND METHODS: In this prospective randomized controlled clinical trial, 25 adults requiring GBR for two common indications-posterior maxillary sinus floor elevation or mandibular posterior extraction socket preservation-were randomized to ACBP (n = 12) or DBBM (n = 13), with collagen membrane coverage in both groups. Radiographic endpoints were indication-specific and were reported separately for sinus and socket sites. CBCT was obtained at baseline and 6 months to assess augmented height (sinus sites) and ridge dimensions at standardized levels (socket sites). At 6 months (implant placement), a 3-mm trephine core was harvested for H&E staining and histomorphometric quantification of vital bone (VB, %) and residual graft material (RG, %). Between-group comparisons used independent-samples t tests (two-sided P < 0.05). RESULTS: All participants completed the 6-month follow-up. VB did not differ significantly between ACBP and DBBM (38.84 ± 8.37% vs. 32.18 ± 11.04%, P = 0.105), whereas RG was significantly lower with ACBP (11.18 ± 5.48% vs. 19.80 ± 8.23%, P = 0.006). CBCT outcomes were comparable between groups, with no significant differences in sinus height gain (7.82 ± 1.52 mm vs. 8.21 ± 4.30 mm, P = 0.852) or socket-related ridge dimensional changes (all P > 0.05). CONCLUSION: Within a 6-month healing interval, ACBP showed CBCT-based dimensional outcomes comparable to DBBM and a lower residual graft fraction with a similar vital bone fraction at implant placement, suggesting that the observed difference was more related to graft turnover than to greater bone formation. CLINICAL RELEVANCE: At routine implant timing (~ 6 months), use of ACBP was associated with a lower residual graft fraction at re-entry while maintaining short-term CBCT-based dimensional stability.

References

1. 1.Rao, S., Zhou, J., Niu, W., Dong, C., Pan, S., & Sun, W. (2026). Partially demineralized allogeneic cancellous bone plug versus deproteinized bovine bone mineral for guided bone regeneration: a pilot randomized controlled clinical trial. Clinical Oral Investigations. https://doi.org/10.1111/clr.12889