Experimental Evaluation of the Effectiveness of Demineralized Bone Matrix and Collagenated Heterologous Bone Grafts Used Alone or in Combination with Platelet-Rich Fibrin on Bone Healing in Sinus Floor Augmentation

Aim:To evaluate the efficacy of platelet rich fibrin (PRF) with or without bone graft [demineralized bone matrix (DBM) graft] in the treatment of intrabony defects based on clinical and radiographic parameters.Materials and Methods:Thirty six intrabony defects in 36 patients were randomly divided into three different groups and were treated with group A (PRF with DBM) or group B (PRF alone) or group C [open flap debridement (OFD)]. Clinical parameters such as plaque index (PI), gingival index (GI), probing depth (PD), relative attachment level (RAL), and gingival recession (GR) were assessed at baseline and 9 months postoperatively; radiographic parameters such as linear bone growth (LBG) and percentage in bone fill (%BF) were calculated by using the image analysis software. Comparisons of groups were analyzed using Kruskal–Wallis analysis of variance test. Pair-wise comparison of groups was done by Mann-Whitney U test.Results:Mean PD reduction and RAL gain were greater in group A (4.25 ± 1.48, 3.92 ± 0.90) and group B (3.82 ± 0.75, 3.27 ± 0.65) than control (3.00 ± 1.21, 2.25 ± 0.62). Furthermore, statistically significant improvement in LBG and %BF was found in group A (3.47 ± 0.53, 61.53 ± 4.54) compared to group B (2.55 ± 0.61, 49.60 ± 14.08) and group C (1.21 ± 0.80, 24.69 ± 15.59).Conclusions:The study demonstrated that PRF improves clinical and radiological parameters compared to OFD alone in intrabony defects. Addition of DBM enhances the effects of PRF in RAL gain and radiographic defect fill.

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“…[ 23 ] In vivo and in vitro studies with DBM showed effective healing, radiographic bone fill, and improvement in clinical parameters. [ 24 25 ]…”

Section: Discussionmentioning

confidence: 99%

Efficacy of platelet rich fibrin in the treatment of human intrabony defects with or without bone graft: A randomized controlled trial

Chandradas

Ravindra²,

Rangaraju³

et al. 2016

J Int Soc Prevent Communit Dent

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“…Corroborating these clinical findings, recent studies showed similar results when adding L-PRF to the graft materials into the maxillary sinus, that is, no beneficial effect on regeneration and new bone formation. 61,62 In these studies, the long graft-healing time did not allow them to verify potential effect of L-PRF in accelerating bone formation.…”

Section: Resonance Frequency Analysismentioning

confidence: 98%

Evaluation of L‐PRF combined with deproteinized bovine bone mineral for early implant placement after maxillary sinus augmentation: A randomized clinical trial

Pichotano

Molon

Souza

et al. 2019

Clin Implant Dent Rel Res

104

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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.

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“…In rabbits, sinus floor augmentation combining PRF with DBM or collagenated heterologous bone did not result in any benefit in terms of bone regeneration (Peker, Karaca & Yildirim, ). Moreover, in sheep a mixture of bovine and autologous bone performed better than PRF, as confirmed by histomorphometry findings (Ocak, Kutuk, Demetoglu, Balcioglu & Ozdamar, )…”

Section: Resultsmentioning

confidence: 99%

The use of bioactive factors to enhance bone regeneration: A narrative review

Donos

Dereka

Calciolari

2019

J Clinic Periodontology

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Aim This review critically appraises the available knowledge on the pre‐clinical and clinical use of bioactive factors for bone regeneration in the cranial and maxillofacial area. Materials and Methods The use of growth factors, amelogenins and autologous platelet concentrates (APCs) for bone regeneration was reviewed in a systematic manner. More specifically, pre‐clinical and clinical studies on ridge preservation, alveolar ridge augmentation, regeneration of peri‐implant defects and sinus augmentation models were considered. Results Amongst different bioactive factors, the highest pre‐clinical and clinical evidence of a positive effect on bone formation is associated with rhBMP‐2 and the lowest with amelogenins. While APCs seem to accelerate clinical healing and reduce postoperative discomfort, there is insufficient and contrasting evidence of a significant effect on hard tissue regeneration for the different clinical applications. Conclusions Although there is increasing evidence that bioactive factors might enhance the bone regeneration process, the great heterogeneity of the available studies and the limited number of RCTs do not allow to draw robust conclusions. Issues that still need to be investigated include the optimal carriers for bioactive agents (direct vs. indirect), the dosage, the timing of administration, as well as the possibility of combining different agents to promote synergistic effects.

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Experimental Evaluation of the Effectiveness of Demineralized Bone Matrix and Collagenated Heterologous Bone Grafts Used Alone or in Combination with Platelet-Rich Fibrin on Bone Healing in Sinus Floor Augmentation

Cited by 14 publications

References 50 publications

Efficacy of platelet rich fibrin in the treatment of human intrabony defects with or without bone graft: A randomized controlled trial

Efficacy of platelet rich fibrin in the treatment of human intrabony defects with or without bone graft: A randomized controlled trial

Evaluation of L‐PRF combined with deproteinized bovine bone mineral for early implant placement after maxillary sinus augmentation: A randomized clinical trial

The use of bioactive factors to enhance bone regeneration: A narrative review

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