Comparative evaluation of bovine versus porcine bone xenografts in maxillary sinus floor augmentation: a systematic review and meta-analysis

Abstract

Deproteinized bovine bone mineral (DBBM) and deproteinized porcine bone mineral (DPBM) are two commercially available xenografts that may be used in maxillary sinus floor augmentation (MSFA). The aim of this study was to compare the efficacy of these two xenografts in MSFA. An electronic search (Embase, PubMed, Cochrane Central Register of Controlled Trials, and Web of Science) and manual search were conducted up until March 2025. Eligible randomized controlled trials (RCTs) were included in the analysis. The Cochrane risk of bias tool was used to evaluate the risk of bias in individual studies. Relevant data were extracted and meta-analyses performed whenever possible. Of the 707 studies identified in the search, six RCTs were included for analysis. Meta-analysis did not show any significant difference in the percentage of new bone formation between MSFA with DBBM and DPBM (mean difference −0.53, 95% confidence interval −1.64 to 0.58; P = 0.35), or in the proportion of residual bone graft (mean difference −2.35, 95% confidence interval −7.39 to 2.70; P = 0.36). However, DPBM tended to show increased resorption characteristics compared to DBBM. In conclusion, DPBM and DBBM showed similar new bone formation and residual graft particles when used for maxillary sinus floor augmentation.