Maxillary sinus augmentation with leukocyte and platelet-rich fibrin and deproteinized bovine bone mineral: A split-mouth histological and histomorphometric study.

Abstract

To evaluate the effect of leukocyte and platelet-rich fibrin (L-PRF) in combination with deproteinized bovine bone mineral (DBBM) on bone regeneration in maxillary sinus augmentation. Thirteen patients (nine males and four females, mean age±SD; 49.92±10.37) were enrolled to the study. 26 maxillary sinus augmentation procedures were randomly performed using DBBM and L-PRF mixture (test) or DBBM alone (control) in a split-mouth design. The same surgical procedures were performed in both groups, and bone biopsies were harvested from the implant sites 6months postoperatively for histological and histomorphometric evaluations as the primary outcome of the study. Implants were placed and then loaded in the augmented sites after 6months. The secondary outcomes included clinical and radiographic data and were obtained pre- and postoperatively. There was no qualitative difference in histological analyses among the groups. In all samples, a newly formed bone was in direct contact with the residual material. The percentages of newly formed bone (test; 21.38±8.78% and control; 21.25±5.59%), residual bone graft (test; 25.95±9.54% and control; 32.79±5.89%), bone graft in contact with the newly formed bone (test; 47.33±12.33% and control; 54.04±8.36%), and soft tissue (test; 52.67±12.53% and control; 45.96±8.36%) were similar among the groups (p<.05). Similar radiographic bone height in the augmented area was observed, and implant survival rate was 100% for both groups. Both techniques were effective for maxillary sinus augmentation, and after 6months of healing, the addition of L-PRF in DBBM did not improve the amount of regenerated bone or the amount of the graft integrated into the newly formed bone under histological and histomorphometric evaluation.