It appears that BMAC offers no statistically significant advantage for regeneration of bone in the maxillary sinus for site preparation of dental implants. BMAC + bovine bone graft results in similar regeneration outcome measures histologically as alveolar bone alone at 3–4 months. Measured histomorphometrically MSCs treated by FICOLL–Hypaque centrifugation to consolidate osteogenic and osteoinductive cells afford no statistically significant advantage for bone regeneration compared to BMAC [11].

The origin of BMAC whether from the iliac crest or proximal tibia appears not to impact histomorphometric improvements in bone regeneration cells, although data are quite limited in BMAC origins [2].

The method of laboratory preparation of BMAC whether single centrifugation or double centrifugation does not improve histomorphometric enhancement of bone regeneration potential inclusion of cells or new bone [12]. Bovine bone graft materials alone appear to consistently result in bone regeneration in the maxillary sinus in preparation for dental implant site preparation enhancement of bone [14].

Further histomorphometric and clinical studies are needed with improved consistency of clinical methods and laboratory preparation of biopsy materials. The samples are evaluated microscopically. An evaluation of the samples in the published studies may produce different interpretations due to variance of thickness of specimens, 7-μm sections in the de Oliveiro paper [12], 30-μm sections for the Payer paper [2], and 300–400-μm sections for the Wildburger paper [15]. Standardized histologic protocols may reduce the imaging interpretation inconsistencies.

Also, stains for bone specimens are not congruent between studies. Azar II + Pararosanilin stains for bone formation determination was used by Wildburger et al. [15] and both Sauerbier et al. papers [11, 14]. Masson’s Trichrome stain, a more conventional histological laboratory stain, was used to assess bone formation in the Pasquali et al. paper [7].

The maxillary sinus lateral wall surgical approaches for site preparation and bone regeneration were fairly standardized in all the papers evaluated. The time of 6 months wound healing is a consistent pattern of assessment and should be continued in future studies [2, 7, 12, 15].