Purpose To investigate the effectiveness of adding leukocyte and platelet‐rich fibrin (L‐PRF) to deproteinized bovine bone mineral (DBBM) for early implant placement after maxillary sinus augmentation. Materials and Methods Twelve patients requiring two‐stage bilateral maxillary sinus augmentation were enrolled to the study. The elevated sinus cavities were randomly grafted with DBBM + L‐PRF (test) or DBBM alone (control) in a split‐mouth design. Implants were placed in the augmented sites after 4 months in the test group and 8 months in the control group. Bone biopsies were collected during implant placement for histomorphometric evaluation. Resonance frequency analysis was performed immediately after implant placement and at implant loading in both groups. Cone‐beam computed tomography was obtained preoperatively and postoperatively for evaluation of graft volume changes. Results Both procedures were effective for maxillary sinus augmentation. Cone‐beam computed tomography analysis did not reveal differences in graft volume between test and control group at any of the evaluated time points (P > .05). Histological evaluation demonstrated increased percentage of newly formed bone for the test group (44.58% ± 13.9%) compared to the control group (30.02% ± 8.42%; P = .0087). The amount of residual graft in the control group was significantly higher (13.75% ± 9.99%) than in the test group (3.59 ± 4.22; P = .0111). Implant stability quotient (ISQ) immediately after implant placement was significantly higher in the control group (75.13 ± 5.69) compared to the test group (60.9 ± 9.35; P = .0003). The ISQ values at loading did not differ between the groups (P = .8587). Implant survival rate was 100% for both groups. Conclusion The addition of L‐PRF to the DBBM into the maxillary sinus allowed early implant placement (4 months) with increased new bone formation than DBBM alone after 8 months of healing.

This case report aimed to describe the effects of leukocyte and platelet-rich fibrin (L-PRF) associated with demineralized bovine bone mineral (DBBM) and absorbable collagen membrane (CM) on bone regeneration in maxillary sinus augmentation. A 59-year-old male patient was referred to the Department of Periodontology for implant rehabilitation of his edentulous upper jaw. The treatment plan involved maxillary sinus augmentation followed by implant installations. A split-mouth design was employed in which the right maxillary sinus was filled using L-PRF, DBBM, and CM; the left side was filled with DBBM and CM. After 4 and 8 months postoperatively, 2 dental implants were installed in each of the right and left maxillary sinuses. Cone-beam computerized tomography (CBCT) was taken before and after sinus augmentation for evaluation of tridimensional bone volume alterations. Bone biopsies were harvested from the implant sites for histomorphometric evaluation. Resonance frequency analysis was employed immediately after implant placement and before prosthetic rehabilitation for evaluation of implant stability. Implants were loaded 10 months after sinus augmentation. CBCT analysis showed a higher resorption rate in the right side of the maxillary sinus (L-PRF + DBBM) compared to the left side (22.25% and 8.95%, respectively). Implant stability quotients were above 68 in all time-points for both groups. Histomorphometric analysis showed a high amount of newly formed bone when L-PRF was used compared with DBBM alone (2 118 102 and 975 535 mm3, respectively). Taken together, both techniques were effective for maxillary sinus augmentation, however the addition of L-PRF to the graft allowed early implant placement and accelerated bone healing in the conditions studied.

Rehabilitation with osseointegrated implants is a therapeutic option consolidated in the literature and has a high rate of success and predictability. However, the loss of dental elements leads to tissue collapse that often make the installation of dental implants unfeasible, causing atrophic defects in the jaws of varying magnitudes. The objective of this case report was to demonstrate the association of a synthetic biomaterial with Fibrin Rich in Platelets (LPRF) with the purpose of gingival tissue augmentation in aesthetic area. The patient underwent preoperative, clinical and radiographic examinations (Cone Beam computed tomography) of the maxilla region with the making of a prototype and one year and four months of follow-up. A homogeneous onlay graft was performed with a cortico-medullary block in the region of the bone defect. After seven months of bone remodeling, the patient underwent a new computed tomography and dental implants were inserted, concomitant with grafting of particulate biomaterial of inorganic mineral hydroxyapatite, which received an association of L-PRF in liquid phase and was later covered with the L-PRF membrane. After six months, a new computed tomography scan was performed to evaluate the previous procedure and followed with the reopening and placement of provisionals with the conditioning of the gingival tissue. After 3 months, personalized molding was performed and the fixed metal-ceramic prosthesis was made in the region of elements 12 to 22. We can conclude with the clinical case that grafting synthetic biomaterial associated with L-PRF proved to be an effective technique in increasing tissue volume.