Space maintenance in autogenous fresh demineralized tooth blocks with platelet-rich plasma for maxillary sinus bone formation: a prospective study.

Eun-Suk Kim,Eun-Young Lee,Ji-Yeon Kang,Jae-Jin Kim,Kyoung-Won Kim

doi:10.1186/s40064-016-1886-1

Abstract

This prospective study evaluated the effectiveness of autogenous fresh demineralized tooth block (Auto-FDT block) with platelet-rich plasma (PRP) for maxillary sinus augmentation with simultaneous implant installation. Auto-FDT block with PRP was used in Group 1 (n = 15) and combined graft (allograft and xenograft) powder with PRP was used in Group 2 (n = 15). For up to 2 years after the final prosthesis was installed, clinical and radiographic examinations were performed to evaluate the amount of graft materials, residual alveolar height (RAH), sinus height (SH) after grafting, augmented graft height (AGH) and resorption height (RH). In ten cases, biopsies were harvested for histological and histomorphometric analyses. A total of 59 implants were placed in a severe atrophic posterior maxilla with less than 5 mm of RAH and sinus augmentation. None of the patients developed sinusitis or other complications, such as implant loss. The graft material extracted included one molar (or 2 premolars) in Group 1 and 1.8 cc in Group 2. The radiologic examination revealed the following average between-group difference SH (Group 1, 14.12 ± 1.63 mm vs Group 2, 16.51 ± 1.29 mm) and AGH (Group 1, 11.62 ± 2.22 mm vs Group 2, 13.65 ± 1.35 mm). However, sufficient SH and AGH were observed for the implants in the Auto-FDT block group. Two years after final prosthesis was installed, no between-group difference in the RH was observed (Group 1, 1.23 ± 0.73 mm vs Group 2, 1.77 ± 0.54 mm, P = 0.021). The histomorphometric analysis revealed no between-group difference in the new bone volume (Group 1, 23.13 ± 1.42 % vs Group 2, 24.18 ± 2.19 %, P = 0.548). The results showed that Auto-FDT block with PRP can be used in grafted sinuses for implants with only one extracted molar (or two premolars). Auto-FDT block with PRP promotes new bone formation that is comparable with combined grafts. Auto-FDT block with PRP is as an alternative to bone grafting and can be a predictable procedure for sinus augmentation.

Highlights

Maxillary posterior tooth loss leads to bone loss in the maxillary sinus floor and increases pneumatization of the maxillary sinus (Hatano et al 2004)
Clinical and radiologic observations All patients were followed for 2 years after the final prosthesis implant
group consisted of patients (Group 1) consisted of 15 patients (10 males and 5 females; mean age 54.9 years; range 39–68 years) who underwent sinus augmentation using Auto-FDT block

Summary

Introduction

Maxillary posterior tooth loss leads to bone loss in the maxillary sinus floor and increases pneumatization of the maxillary sinus (Hatano et al 2004). The placement and integration of implants in the maxillary posterior edentulous area requires sinus floor augmentation. An average of 5–6 cc of autogenous bone is required for one sinus. An average of 2–3 cc of bone is required (Peleg et al 2004). To solve these problems, some studies have demonstrated bone formation using the patient’s own blood or platelet-rich plasma (PRP) to fill void without bone grafts (Chen et al 2007; Mazor et al 2004; Moon et al 2011). The augmented height and area are significantly decreased in the sinus augmentation using blood clot without bone grafts

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Discussion

Conclusion