Sole Grafting Material Research Articles

Maxillary Sinus-Floor Augmentation by Porcine-Apatite Xenograft: A Prospective Case Series Study.

Bone substitutes sometimes are unsuccessful in replacing the autogenous bone graft, combining the advantages and disadvantages to achieve satisfactory results. The aim of this work was to clinically and histologically evaluate the outcome of porcine-apatite xenograft used to elevate the maxillary sinus floor in severe atrophy ridge. A two-stage crestal window sinus lift protocol was conducted in 24 patients with crestal bone ≤2mm. Highly porous porcine carbonate apatite moistened with saline solution was placed in the elevated sinus cavity as the sole grafting material. Bone core biopsies were taken at 6, 9 and 12 months after the sinus augmentation surgery at the time of implant placement. The treatment outcome was assessed using the μCT (micro computed tomogram) and histological analysis. Statistical analysis was performed using the nonparametric Kruskal-Wallis test, followed by the post-hoc Dunn multiple comparison test. At 6 months after implant placement, all implants achieved good primary stability (≥ 30 Ncm of insertion torque) and successfully osseointegrated. The residual graft amount (m±SE) was low (11.91±1.99%) at 6 months, and further decreased (6.11±2.64%) at 12 months after the sinus augmentation surgery. On the contrary, the amount of new bone detected was 18.94±4.08% at 6 months, and significantly (p<0.05) increased (40.16±5.27%) 12 months after sinus augmentation surgery. Histological assessment revealed existing of osteoclasts in resorbing the graft as well as the osteoblasts in forming the new bone. In the severely atrophic maxilla, the porcine-apatite xenograft promotes new bone formation while being slowly absorbed. In conclusion, within the limited sample size, the porcine-apatite xenograft seems to be a good material to be used as the graft material for crestal window sinus augmentation.

Radiological Evaluation and Biomechanical Stability of Implants Simultaneously Placed at the Sites with Sole Advanced Platelet-Rich Fibrin (A-PRF) Grafted Sinus Floor.

In this retrospective study stabilities of 24 implants simultaneously placed at posterior maxillae with sinuses grafted by advanced platelet rich fibrin (A-PRF) and newly formed bone around them were evaluated. Fourteen augmented maxillary sinuses of 11 patients with a mean residual alveolar bone height of 4.55mm were involved in this study. Maxillary sinus lifting via lateral window approach and implant site osteotomy were performed, and prepared A-PRF clots were used as sole graft material. Each of the implants was immediately placed with a good primary stability. Postoperative sixth month tomography images were compared with preoperative ones in order to calculate the gained bone height and implant stability quotient (ISQ) values were recorded. The new vertical mean bone height of 24 implant sites was 12.21mm with an implant survival rate of 100%. ISQ values of the implants were ranging from 62 to 75 with a mean value of 68. Statistically the diameter of implant did not have any effect on new bone formation and the ISQ values, however the length of them did. A-PRF as a graft material for sinus lifting with simultaneous implant placement is a reliable technique with its low cost and lack of immunogenic reaction risk.

Flapless osteotome-mediated sinus floor elevation using platelet-rich fibrin versus lateral approach using deproteinised bovine bone mineral for residual bone height of 2-6mm: A randomised trial.

To evaluate patient-reported outcomes and radiographic results of simultaneous implant placement in severely atrophic maxilla using flapless endoscope-assisted osteotome sinus floor elevation with platelet-rich fibrin (PRF), also defined as PESS, and to compare the results with those of lateral sinus floor elevation (LSFE). Patients with a residual bone height (RBH) of 2-6mm were included in a randomised controlled trial. PESS was performed with PRF as the sole grafting material. LSFE was performed using deproteinised bovine bone matrix. Patient-reported outcomes were recorded on a visual analogue scale (VAS-pain) and visual rating scale (VRS-swelling and VRS-willingness). Peri-implant bone height (PBH), bone mineral density (BMD) and sinus grafting remodelling index were measured using CBCT immediately postoperatively and 3rd, 6th and 18th months post-surgery. The study population consisted of 20 patients in each group. The RBH of two groups averaged 3.35±0.79mm and 2.92±0.63mm with no significant difference (p>.05). VAS-pain was 18.0 (IR 15.0-22.5) and 35.0 (IR 32.5-37.0) in the PESS and LSFE groups, respectively (p<.01). VAS-pain decreased with time in both groups. VRS-swelling was lower in the PESS group than LSFE group. VRS-willingness was higher in the PESS group than LSFE group (p<.01). At 18months post-surgery, the marginal bone loss was 0.60±0.25mm and 0.69±0.35mm in the two groups with no significant difference (p=.52). Within the limitations of this study, PESS was associated with lower postoperative morbidity and was more tolerable than LSFE. PESS could be a reliable procedure for sinus floor elevation in patients with insufficient RBH.

The role of leukocyte- and platelet-rich fibrin as a sole grafting material in alveolar ridge preservation: a clinical radiographic study

ENWEndNote BIBJabRef, Mendeley RISPapers, Reference Manager, RefWorks, Zotero AMA Al Kassar M, Heshmeh O. The role of leukocyte- and platelet-rich fibrin as a sole grafting material in alveolar ridge preservation: a clinical radiographic study. Journal of Stomatology. 2023. doi:10.5114/jos.2022.124301. APA Al Kassar, M., & Heshmeh, O. (2023). The role of leukocyte- and platelet-rich fibrin as a sole grafting material in alveolar ridge preservation: a clinical radiographic study. Journal of Stomatology. https://doi.org/10.5114/jos.2022.124301 Chicago Al Kassar, Mohamad, and Omar Heshmeh. 2023. "The role of leukocyte- and platelet-rich fibrin as a sole grafting material in alveolar ridge preservation: a clinical radiographic study". Journal of Stomatology. doi:10.5114/jos.2022.124301. Harvard Al Kassar, M., and Heshmeh, O. (2023). The role of leukocyte- and platelet-rich fibrin as a sole grafting material in alveolar ridge preservation: a clinical radiographic study. Journal of Stomatology. https://doi.org/10.5114/jos.2022.124301 MLA Al Kassar, Mohamad et al. "The role of leukocyte- and platelet-rich fibrin as a sole grafting material in alveolar ridge preservation: a clinical radiographic study." Journal of Stomatology, 2023. doi:10.5114/jos.2022.124301. Vancouver Al Kassar M, Heshmeh O. The role of leukocyte- and platelet-rich fibrin as a sole grafting material in alveolar ridge preservation: a clinical radiographic study. Journal of Stomatology. 2023. doi:10.5114/jos.2022.124301.

Lateral Sinus Floor Elevation in the Severely Atrophied Maxilla: Concentrated Growth Factors Versus Bone Substitutes. A Controlled Clinical Trial

The present study clinically and radiographically compares the outcome of implants inserted in maxillary sinuses augmented with concentrated growth factors (CGFs) or demineralized bovine bone matrix (DBBM) in a one-stage lateral approach. In 20 patients with a residual bone height of 1 to 4 mm, lateral sinus floor elevation was performed, using CGFs or DBBM as the sole grafting material, with simultaneous implant placement. Outcome variables were implant and prosthesis failures, complications, subjective satisfaction, and radiographic changes in marginal bone level (MBL) 12 months after surgery. The patients were consecutively recruited: 10 to the CGF group and 10 to the DBBM group. No implant failed in either group at 12 months postsurgery, and there were no complications. There was no statistically significant difference in MBL change between the CGF and DBBM groups (difference of -0.3 mm, favoring the CGF group; 95% confidence interval [CI]: -0.8 to 0.2; P = .18). There was no statistically significant difference in satisfaction (difference of 0.2, favoring the CGF group; 95% CI: -0.2 to 0.6; P = .29). Within the limitations of the present study, the lateral sinus floor elevation performed with the use of CGFs as the sole grafting material showed implant survival rates and marginal bone level changes comparable to DBBM grafting.

Evaluation of the effect of PRF on bone healing in diabetic animals after periradicular surgery

Objective: was directed to evaluate platelet rich fibrin alone and in combination with xenograft as an alternative to bone substitute in treatment of critical sized bone defects in dogs. Material and methods:8 dogs were selected for this study in which diabetes mellitus was induced. Root canal treatment was done in the 2nd and 4th premolar teeth of both sides then 4 critical sized bone defects were created in relation to the distal root of the selected teeth. According to the bone cavity filling materials there was 4 groups xenograft, xenograft and PRF, PRF and blood clot groups. Dogs were sacrificed at 4 days,2,5and 9 weeks the mandibles were harvested for DEXA evaluation. Results: bone density measurement at 9 weeks was significant with Xenograft and PRF group than Xenograft, PRF and blood clot groups, and at the same time there was no significance between Xenograft and PRF groups. Conclusion: PRF is a valuable material that can be used as a sole grafting material in periradicular surgery to improve bone regeneration.

Comparison Study of the Histomorphometric Results after Socket Preservation with PRF and Allograft Used for Socket Preservation-Randomized Controlled Trials.

The aim of the present clinical study was to assess and compare the histomorphometric results and efficacy of freeze-dried bone allograft (FDBA) in combination with platelet-rich fibrin (PRF), and PRF as a sole grafting material for socket preservation. Ninety patients in need of tooth extraction and implant restoration were included in this study. The participants were randomly divided into three groups based on post-extraction clinical protocol: socket preservation procedure with allograft in combination with a PRF membrane (PRFm), PRF as a sole grafting material, and a control group. A total of 90 implants were placed four months post-extraction. During the surgical re-entry a bone biopsy was harvested with a trephine drill. Histological samples were prepared and analyzed for percentage vital bone and connective tissue. One-way ANOVA with Bonferroni post-hoc analysis were used to assess the results. Both test groups revealed a significantly higher percentage of vital bone formation compared to the control group. No statistically significant differences regarding vital bone formation and connective tissue quantity between the tested groups were observed (FDBA + PRFm: 3.29 ± 13.03%; and PRF: 60.79 ± 9.72%). From a clinical and histological point of view, both materials in the test groups are suitable for the filling of post-extraction sockets without bone defects. Both of the tested groups revealed a significantly higher percentage of vital bone formation compared to the control group.

EFFECTIVENESS OF PLATELET RICH FIBRIN (PRF) AS A SOLE GRAFT MATERIAL VERSUS NANO-CRYSTALLINE HYDROXYAPATITE IN MAXILLARY SINUS AUGEMENTATION WITH IMPLANT PLACEMENT SIMULTANEOUSLY.: A RANDOMIZED CONTROLLED CLINICAL TRIAL

Aim: The aim of this study was to evaluate the effectiveness of platelet rich fibrin (PRF) as sole graft material versus Nano crystalline hydroxyapatite in maxillary sinus augmentation with implant placement simultaneously. Patients and Methods: This was a randomized controlled clinical trial conducted on 18 patients suffering from atrophied maxillary ridge (less than 5 mm in bone height) for implantation indicating the need for maxillary sinus floor augmentation before implant placement. Group (A) received sinus augmentation with nano crystalline hydroxyapatite with immediate implantation (Nano bone ARTOSS GmbH hydroxyapatite particles) and Group B received sinus augmentation with PRF as sole graft material with immediate implantation. All patients were followed up for 6 months recording the progress of the healing both clinically and radiographically via CBCT and to evaluate the new bone formation. Results: Surgeries went uneventful in patients of both groups. No notable complications occurred during the surgical procedures and the healing period of the two groups. Radiographic results after 6 months showed that there was no statistically significant difference between the two groups. The highest mean value was found in (Group B) while the least mean value was found in (Group A). All implants were clinically stable at the time of abutment insertion, 6 months after sinus augmentation. Conclusions: The use of the PRF as a sole graft material in maxillary sinus augmentation proved to be a successful material that offers sufficient amount of natural bone in the sinus that cover all the surface of the inserted implant.

Autologous platelet-rich fibrin as a sole grafting material in regeneration of large periapical (palatal) defects: Report of four consecutive cases

The maintenance of a tooth with periapical lesion is more often managed by periradicular surgery when the efforts using conventional endodontic (re) treatment prove insufficient to achieve desired outcome. The most critical elements of successful bone regeneration involve the production hermetic seal of the endodontic canal after the root end resection and promotion of early uneventful wound healing using desirable biomaterials, particularly in large-sized intraosseous periapical defects. Yet even after the use of different biomaterials available, the wide varieties of such defects have shown suboptimal outcomes and also took longer healing period. The simple procurement method, ready bioavailability, cost-effectiveness, ease of handling, and remarkable healing potential of platelet-rich fibrin (PRF) in filling the large-sized periapical intrabony defects is presented in this article, with the aim of providing optimal and most elusive environment for wound healing in regenerative procedure. The entire intrabony defects were condensed with autologous PRF as the only grafting material in all four different cases for regeneration. The same surgical technique successfully applied to all four selected cases resulted in an uneventful healing post surgically and almost complete defect fill over 6 months' follow-up. The use of autologous PRF can be recommended for further research in view of its therapeutic use in large-sized intraosseous defects even in different health disciplines; to support the successful outcome identified in this case series.

Lateral Sinus Augmentation Using L-PRF as Sole Graft Material

Lateral Sinus Augmentation Using L-PRF as Sole Graft Material

Noticeable Bone Regeneration beyond the Implant Tip after A Crestal Approach Sinus Lift Using Only Platelet Rich Fibrin: A Report of Two Cases

Purpose: To present two cases with noticeable bone gain beyond the implant tip after a crestal approach sinus lift using PRF as the sole grafting material. Materials and Methods: Two PRFs were packed into each implant hole to elevate the Schneiderian membrane and sandblasted acid-etched implants were inserted simultaneously. Results: The follow-up panoramic radiographs and CTs showed that the new sinus floor was above the implant tip and the cortical outline was clear. Conclusion: The findings from both cases suggest that the PRF can promote noticeable bone gain in the crestal approach sinus lift procedure. A greater number of patients and a longer follow-up period are needed to investigate the reliability of this technique.

Evaluation of the effectiveness of using platelet rich fibrin (PRF) as a sole grafting material and membrane in augmentation of dehiscence and fenestration defects encountered during dental implant surgery

Background: Bone regeneration in dehiscence and fenestration defect can be improved with the use of platelet rich fibrin (PRF) that provides a scaffold for new bone regeneration. This study was conducted to assess the effectiveness of PRF as a graft material and membrane in dehiscence and fenestration defects. Materials and Methods: This prospective clinical study included patients who received dental implants that demonstrated peri-implant defects which were augmented using Leukocyte- PRF (L-PRF) or Advanced-PRF (A-PRF). Twenty four weeks postoperatively the defect resolution and the density of regenerated bone were assessed by CBCT and re-entry surgery. The assessment also included measurement of primary and secondary implant stability using Periotest® M, success rate and complication rate of the installed implants. Results: The mean overall intraoperative defect size was 29.44 (± 14.1) mm2, postoperatively it became 2.07 (± 3.6) mm2 with a statistically significant difference (p= &lt; 0.0001). There was no significant difference between L-PRF and A-PRF. Defect resolution ranged from 80% to 100% with a mean of 95.7% (± 6.7%). Defects that showed complete resolution were significantly smaller in size (21.2± 7 mm2) than those that showed partial resolution (44.4± 11 mm2). The overall mean primary stability recorded was 2.9 (± 1.6) Periotest values (PTV) and overall mean secondary stability was -0.22 (±1.4) (P&lt;0.0001).The overall mean HU of the newly formed peri-implant bone was 385.7 (± 77.4). Conclusions: PRF as the sole graft material for peri-implant defects results in complete defect resolution in small to moderate defects, larger defects may require the addition of bone substitute to achieve complete defect resolution.

Simultaneous sinus floor elevation and implant placement using leukocyte- and platelet-rich fibrin as a sole graft material.

Sinus floor elevation (SFE) and simultaneous implant placement is predictable and reproducible. However, the graft material for the antral cavity remains a topic of debate. Considering the high osteogenic potential of the sinus membrane, most graft materials are generally accepted. This study aimed to assess the outcome of simultaneous SFE and implant placement, using leukocyte- and platelet-rich fibrin (LPRF) as a sole graft material. This study was designed as a single cohort prospective study. Clinical and radiographic measurements (cone beam computed tomography [CBCT]) were performed immediately after implant placement and at abutment connection (6 months later). The amount of newly formed bone was linearly recorded on cross-sectional images. Four measurements (mesial, distal, buccal, palatal) were registered with the axis of the implant as reference. Six lateral and 22 transalveolar SFEs were performed in 26 patients with simultaneous implant placement. Six months after surgery, 27/29 implants were clinically integrated. The mean vertical bone gain was 3.4 ± 1.2 mm and 5.4 ± 1.5 mm for transalveolar SFE and lateral SFE, respectively. The level of the new sinus floor was in all cases in continuation with the apex of the implant, and the peri-implant crestal bone height was stable. L-PRF as a sole graft material during simultaneous SFE and implant placement proved to be a practical, safe, and economical subsinus graft material, resulting in natural bone formation.

Short term dimensional bony changes following teeth extraction in the esthetic zone and the use of PRF as a sole grafting material: Randomized controlled trial

Background: Bone loss after teeth extraction is a repeated observation in dental practice. Many bio materials were used inalveolar socket augmentation including platelet rich fibrin (PRF) to decrease bone loss.Purpose: The aim of this study was to investigate the effect of PRF when used as a sole grafting material on the ordinarydimensional bony changes following teeth extraction in the aesthetic zone.Patients and Methods: 42 fresh extraction sockets in 27 patients were included in this study. Subjects were randomly allocatedinto 3 groups. Study group included sockets augmented with PRF, second group included sockets augmented with xenograftand the third negative control group included patients were extraction was done with no augmentation. Subjects were assessedradiographically after extraction and before implant placement at 3 and 6 months post extraction using CBCT superimpositionto assess horizontal and vertical bone loss.Results: The amounts of horizontal and vertical bone loss were significantly higher at 3 and 6 months in PRF group whencompared to xenograft group. PRF as a socket grafting has no additive effect on decreasing bone resorption in the short termperiod after teeth extraction in the esthetic zone.

Comparative Study of Bone Formation around the Implant Surface Following Simultaneous Sinus Membrane Elevation and Implant Placement With and Without Platelet Rich Fibrin.

Brief Background Rehabilitation of edentulous posterior atrophic maxilla has always been an exigent task in the field Implantology. Studies have shown, the use of Choukron’s platelet rich fibrin as a sole grafting material in sinus floor and immediate implant placement leading to bone formation in the peri-implant region. Purpose of the Study This study was conducted as novel research where, Direct Sinus Membrane elevation and simultaneous Implant placement without any bone graft resulted in bone formation in sub-antral space. This study compares and evaluates the bone formation with the help of Cone Beam CT Scan (CBCT) in sub-antral space following direct sinus membrane elevation and simultaneous implant placement and platelet rich fibrin as the sole graft. Materials and Methods 48 patients who fulfill the inclusion criteria were divided as Group I- direct sinus membrane elevation and implant placement without any graft and Group II- direct sinus membrane elevation and implant placement along with PRF as sole graft Results and Analysis Unpaired‘t test’ was used where, we ‘p’ value was compared with the level of significance. On comparing the peri-implant bone density in Hounsefield units, in CBCT scans; the bone density was more in group II which was statistically significant (p&lt;0.05). Summary and Conclusions PRF has proved to be a valuable autologous augmenting material in direct sinus membrane elevation and simultaneous implant placement in edentulous posterior maxilla. Key Words Hounsefield Units, Sub-antral space, Peri-implant, Cone Beam CT Scan.

Actual quantitative attachment gain secondary to use of autologous platelet concentrates in the treatment of intrabony defects: A meta-analysis.

Background:There are no authoritative meta-analyses and no clear quantitative assessments available estimating effects of open flap debridement (OFD) combined with platelet-rich fibrin (PRF) or platelet-rich plasma (PRP) over and above that of OFD. This study evaluated the actual quantitative mean gain for various clinical (clinical attachment level [CAL], probing pocket depth [PPD] and gingival marginal level [GML]) and radiographic (intrabony defect depth [IBD]) parameters of Platelet Concentrates- PCs (PRP/PRF) as sole grafting material along with OFD and OFD alone in the treatment of intrabony defects.Materials and Methods:A detailed electronic search was carried out in PUBMED/MEDLINE, COCHRANE, EBSCOHOST, and Google Scholar databases by unifying related search terms with additional hand searches in select specialty journals up to May 2017. The eligibility criteria included human randomized clinical trials, either of a parallel group or a split-mouth design with follow-up period of at least 6 months. Periodontal intrabony defects with radiographic IBD ≥3 mm with corresponding CAL ≥5 mm were included. For the meta-analysis, the inverse variance method was used in fixed- or random-effect models.Results:Actual quantitative mean gains were calculated for OFD with PRF/PRP (CAL = 1.1 mm, IBD = 1.68 mm, PPD = 0.97 mm and GML = 0.48 mm) over and above that of OFD alone.Conclusion:Because of very high heterogeneity, the results may not be dependable. Apart from gains in radiographic bone fill, all other periodontal clinical parameters showed negligible gains. Using PRF technologies in periodontal intrabony defects may not be of great clinical significance over and above that of OFD alone, the effect sizes are also not large enough.

Evaluation of Clinical Effectiveness of Bioactive - Glass and Platelet - Rich Fibrin in the Management of Intrabony Defects - A Comparative Study

Background: Platelet-Rich Fibrin (PRF), the second-generation platelet concentrate has various fringe benefits over other platelet concentrates. Just finite number of research works have concentrated on the utilization of PRF in combination with various kinds of bone grafts in intra-bony defects. Objective: The primary intention of this study was to determine the clinical and radiographical efficacy of Bioactive-glass with and without autologous PRF in the management of three-wall vertical defects. Methods: Twenty intrabony defects were arbitrarily chosen and treated either with Bioactive Glass (BG) alone or in mix with PRF (PRF/BG). Clinical parameters were documented preoperatively (baseline) and at six months post-operatively. Radiographic analysis was performed at baseline, third and sixth-month intervals. Results: The study outcome demonstrated that both treatment approaches were effectual. Significant decrease in the mean probing depth and gain in clinical attachment was observed in BG+PRF and BG groups as compared to baseline but was statistically insignificant at 6 months. (p=0.475, p=0.245 respectively). Radiographically, reduction in defect depth was significantly greater in BG+PRF group than BG group (p=0.007) at 6 months. Conclusion: Within the limitation of the current study, it is proposed that both treatment modalities are effective in the management of 3-wall intra-bony defects. The outcomes additionally uncovered that incorporation of PRF with BG has more successful and promising results. Hence in future, clinical trials with bigger sample size may be employed to further explore the potential benefits of PRF as a sole grafting material.

PC377: Tissue engineering: platelet rich fibrin as a sole graft material for sinus augmentation

PC377: Tissue engineering: platelet rich fibrin as a sole graft material for sinus augmentation

PC485: The promising clinical and radiographical results of titanium‐prepared platelet‐rich fibrin (T‐PRF) as a sole graft material for management of periimplantitis

PC485: The promising clinical and radiographical results of titanium‐prepared platelet‐rich fibrin (T‐PRF) as a sole graft material for management of periimplantitis

Evaluation of effectiveness of platelet-rich fibrin for ridge preservation after atraumatic extraction: A case series

Purpose: The present study was undertaken to evaluate the effectiveness of platelet-rich fibrin (PRF) for ridge preservation after atraumatic extraction. Materials and Methods: Seven patients with a nonrestorable tooth requiring extraction followed by implant placement were treated in this study. After atraumatic extraction, the socket was filled with PRF as the sole grafting material in preparation of placing an implant after wound healing. At the time of extraction and 3 months later, vertical and horizontal socket dimensions were measured clinically and radiographically. Results: The measurements of buccolingual dimension of the socket immediately after extraction and at 3-month postsurgery were recorded. The mean buccolingual measurement of socket at baseline was 10.0 ± 1.6 mm. Postoperatively, 3 months after ridge preservation, the mean buccolingual measurement was 9.4 ± 1.6 mm showing minimal changes. The radiographic vertical bone level at baseline was 14.1 ± 1.0 mm and 3 months postoperatively 12.7 ± 0.8 mm showing minimal changes in apicocoronal dimension. Conclusion: The ridge preservation using PRF as space filler after atraumatic extraction was found to be an effective procedure for the placement of implants.