This study aimed the to investigate the beneficial effect of combining PTH with bovine-derived bone graft bone in maxillary sinus augmentation. There is limited information available about the effect of PTH on maxillary sinus augmentation to achieve a clear understanding of PTH's efficacy in bone regeneration and bone remodelling through radiological, clinical, biomarker, histological and histomorphometric assessment . Objectives 1. Evaluation of the bone density at the planned implants sites using cone beam computed tomography (CBCT). 2. Histomorphometry examination of maxillary sinus bone to measure (bone trabeculae, connective tissue, osteoblast, osteocyte) after healing 4 months after augmentation. 3. Osteopontin as biomarker analysis for bone regeneration and osteoblast activity. 4. Evaluate the primary stability of implant in upper posterior area filled with PTH (1 34) and bovine-derived bone graft compared to bovine-derived bone graft alone.
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Bone density
Timeframe: follow up after 20 weeks after maxillary sinus augmentation
Histomorphometrical analysis of bone biopsy
Timeframe: 20 weeks after augmentation
Osteopontin Analysis from bone core biopsy
Timeframe: 20 weeks after augmentation
Mohanad Ali Ali Shabat, Msc,PhD student in Oral surgey