The aim of this study is to analyze a clinical case about the combined influence of Choukroun’s platelet-rich fibrin (PRF) membranes and particulate xenogenous bone graft materials on the healing and rehabilitation of atrophic maxilla with the surgical technique of sinus lift.
Materials and methods: The case involves a 35 years old female patient with radiographic and clinical manifestation of maxillary atrophy.
After preparation of the site with sinus lift, the surgical technique uses integration of membranes of autogenous PRF in the implant site and insertion of particulate xenogenous bone graft (Bio-Oss ®). In the same surgical time two implants are inserted.
The case is evaluated with clinical observation and with panoramic radiography 4 months after the surgical bone augmentation. Bone density showed a significant increase in clinical observation and panoramic radiography control.
Implants succeeded in guarantee the primary stability, without healing defects and bone dehiscence The panoramic radiography shows vertical and horizontal bone augmentation, significant density of the new generated bone without fenestrations around implants.
The use of PRF membranes as an integration of particulate xenogenous bone grafts in the rehabilitation of atrophic maxilla with the surgical technique of sinus floor elevation is an innovative procedure, that integrates the actual knowledge about the protocols of bone tissue regeneration in the maxilla. Particulate Xenogenous bone grafts, like Bio-Oss ®, are widely considered valid substitutes of autogenous bone for sinus lift procedures of atrophic maxilla.
There is no scientific evidence about a more significant healing efficiency of any surgical technique in horizontal and vertical bone augmentation respect to other techniques. It is unclear whether augmentation procedures at immediate single implants placed after sinus lift with PRF integration can assure results that are clinically more efficient than the use of Xenogenous bone grafts.
PRF membranes, providing a quantity of fibrin matrix, leukocytes, platelets, and growth factors, demonstrates however valid potentiality of stimulation of neo-angiogenesis and bone formation around implants and this combined technique is surely a very interesting technique that requires a more perspective long-term experimental evaluation, including a more significant number of patients, with clear and rigid criteria of selection of the cases, in order to avoid the risk of bias.
F. Inchingolo 1-4, A. D. Inchingolo1, M. Tatullo 2, M. Marrelli 4 , A.M. Inchingolo 3, F. Carbotti 1, A. Palladino 1, M. De Carolis 1, V. Angelini 1 , A.D. Inchingolo1, G. Dipalma1-4
1 Department of Odontostomatology and Surgery, University of Bari, Bari, Italy
3 Department of Odontostomatology and Surgery, University of Milano, Milano, Italy
4Department of Maxillofacial Surgery, Calabrodental Srl, Crotone, Italy