Maxillary sinus augmentation is indicated when there is an inadequate vertical alveolar bone height to effectively support surgically placed dental implants. The sinus elevation procedure requires grafting bone material onto the sinus floor to regenerate sufficient vertical alveolar bone height [1, 2]. The ideal bone grafting material should be biocompatible, possess no risk of disease transmission, promote bone regeneration, and have mechanical stability throughout the healing period [3]. Autologous bone is the “gold standard” of bone grafting materials in maxillary sinus lifts due to its osteoconductive, osteoinductive, and osteogenic potential [4, 5]. The harvesting of autologous bone is highly invasive and time-consuming and has variable outcomes for donor and recipient sites [5, 6]. Current biomaterials like xenografts, homologous grafts, and synthetic grafts circumvent the risks of autologous grafts but lack cellularity [7]. Bone marrow aspirate concentrates (BMACs) alone and biomaterials enriched with BMACs were proposed to have the potential to increase the success of sinus floor elevation surgeries, rather than biomaterials alone [8]. Autologous bone marrow is a known source of undifferentiated mesenchymal cells that can differentiate into osteoblasts [9] and produce vascular endothelial growth factors [10].

The technique involving bone marrow-derived mononuclear cell (MNC) isolation by synthetic polysaccharide (FICOLL) is considered an optimum approach for harvesting of MNCs [11]. It is primarily used in orthopedics and requires good manufacturing practice laboratory techniques. Thus, the closed bone marrow aspirate concentrate (BMAC) system which can be done chairside has become an accepted means to harvest MNCs [12].

The objective of this systematic review is to evaluate the histomorphometric outcomes of BMAC harvested chairside on regeneration of bone in maxillary sinuses grafted for implant site development.