Sauerbier et al. [14] further compared BMAC + bovine bone grafts (test group) with alveolar bone, autologous + bovine bone grafts (control group) for maxillary sinus site preparation. New bone (31.3%) for the test group compared with new bone (19.3%) for the control group statistically indicated equivalence in histomorphometric outcome. Histologic images showing impressive new bone formation were presented. BMAC + bovine bone was equivalent to alveolar bone + bovine bone 3–4 months postsurgically. Histologic diagnosis employed standardized formalin-fixed preparations, serially dehydrated with alcohol in increasing concentrations. In addition, 100-μm sections were analyzed and data reported in bar graphs of BMAC + bovine bone vs alveolar bone alone. Proof of multipotency for three cell types demonstrated that chondrogenic, adipogenic, and osteogenic activities were present.

Payer et al. [2] compared BMAC derived from tibia + bovine bone (test group) to bovine bone alone (control) for maxillary sinus augmentation. Comparisons at 3 and 6 months were recorded with Periotest and radiographs. And similar results were reported. BMAC derived from the tibia resulted in no benefit for bone regeneration but was suitable as a donor for bone grafts. Due to “high variation of data” and “low number of patients” in this study, these outcomes need further evaluation. Histologic analyses for this study employed 30-μm-thick histologic samples. Images for new bone formation were evaluated for percentage bone contact with software programs. Flow cytometry diagnosed phenotype of bone marrow stromal cells demonstrating the same immunophenotype for cells.

Wildburger et al. [15] compared mesenchymal bone cells + bovine bone (test group) with bovine bone alone (control) in seven patients requiring bilateral maxillary sinus lift site preparation surgeries. Three months postsurgically, bone biopsies were taken with implant drills. New bone (13.5%) for the test group was compared with new bone (13.9%) for the control group. There was no statistical difference in the test vs control bone graft groups in the maxillary sinus. Histologic diagnosis evaluation for this study employed 300–400-μm-thick specimens. Azar II + Pararosanilin stains were used to evaluate new bone formation (red stain) vs bovine bone (green stain). Fluorescence-activated cell sorting (FACS) analyses of cell cultures confirmed cell differentiation.