Abstract

BackgroundVarious technologies of autologous blood concentrates are currently evaluated for their potential to enhance bone formation.AimTo report on the histological outcome of maxillary sinus floor augmentation (MSFA) with deproteinized bovine bone (DBB) in combination with chair-side prepared autologous platelet-rich growth factor (PRGF), in comparison to that with DBB alone.Materials and methodsSix partially edentulous patients with ≤ 3-mm residual bone height bilaterally in the posterior maxilla were subjected to MSFA with the lateral window technique, using DBB in combination with PRGF (PRGF System1 Vitoria, Spain) on one side or DBB alone on the contralateral side. Cylindrical biopsies from the augmented sinuses were collected during implant installation, ca. 6 months post-MSFA, and subjected to non-decalcified histological and histomorphometric evaluation.ResultsThe collected biopsies varied in length (range 3.5–9.9 mm); consequently, the portion of the biopsy representing augmented tissues also varied (range 2.3–14.6 mm2). New bone formation with a trabecular appearance and numerous DBB particles in contact with the new bone or with loose connective tissue were observed. No differences in the relative volumes of bone formation were found in sinuses augmented with DBB + PRGF or DBB alone 6 months after MSFA (35.6 ± 8.26 mm and 37.8 ± 3.15 mm, respectively).Conclusion and clinical implicationsIn conclusion, based on these preliminary results, PRGF as adjunct to DBB for MSFA, except from improved handling during the operation, does not appear to enhance nor interfere with bone formation inside the human sinus 6 months after MSFA, compared with the use of DBB alone.

Highlights

  • Maxillary sinus floor augmentation (MSFA) is a standard procedure to re-establish adequate bone volume and ridge height for implant installation in the posterior maxilla

  • In one human histological case series with five patients [30], platelet-rich growth factor (PRGF) + deproteinized bovine bone (DBB) resulted in increased vascularization and increased bone formation 5 months after maxillary sinus floor augmentation (MSFA) compared with only DBB implantation

  • Handling and placement of DBB into the sinus were considerably improved when combined with PRGF (Fig. 2)

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Summary

Introduction

Maxillary sinus floor augmentation (MSFA) is a standard procedure to re-establish adequate bone volume and ridge height for implant installation in the posterior maxilla. Several technologies of chair-side, autologous blood concentrates have been proposed as growth factor (GF) sources [17]. These autologous blood concentrates consist of a volume of plasma enriched with a large number of platelets (i.e., platelet-rich constructs) which, after activation, they release GFs (e.g., platelet-derived growth factor (PDGF), transforming growth factor beta (TGF-b), insulin-like growth factor (IGF), vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), and hepatocyte growth factors (HGF), with the potential to. Plasma-rich in growth factors (PRGF) [21] is such autologous blood-derived concentrate and has been described to enhance bone formation in bone defects, including MSFA [21,22,23,24]. Various technologies of autologous blood concentrates are currently evaluated for their potential to enhance bone formation

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