Histological and Histomorphometric Evaluation of Applying a Bioactive Advanced Platelet-Rich Fibrin to a Perforated Schneiderian Membrane in a Maxillary Sinus Elevation Model

Abstract

BackgroundSchneiderian membrane (SM) perforation is a major complication of maxillary sinus elevation with simultaneous bone grafting, yet under this scenario there is no standard biomaterial that maximizes favorable tissue healing and osteogenic effects.PurposeTo compare the effect of advanced platelet-rich fibrin (A-PRF) and collagen membrane (CM) on a perforated SM with simultaneous bone grafting in a maxillary sinus elevation model.Materials and MethodsAfter perforation of the SM was established, 24 animals were randomly divided into two groups: (i) group CM: CM and deproteinized bovine bone mineral (DBBM) (n = 12), (ii) group A-PRF: A-PRF and DBBM (n = 12). Radiographic and histological evaluations were performed at 1 and 4 weeks post-operation.ResultsAt 1 week, an intact SM was found in group A-PRF. At each time point, the number of inflammatory cells at the perforated site was higher in group CM, and the area of new osteoid formation was significantly greater in group A-PRF (p < 0.0001). At 4 weeks, the osteogenic pattern was shown as from the periphery to the center of the sinus cavity in group A-PRF.ConclusionThe higher elasticity, matching degradability, and plentiful growth factors of A-PRF resulted in a fully repaired SM, which later ensured the two osteogenic sources from the SM to generate significant new bone formation. Thus, A-PRF can be considered to be a useful bioactive tissue-healing biomaterial for SM perforation with simultaneous bone grafting.

Simultaneous Implant Placement and Sinus Lift Using Leukocyte-Platelet Rich Fibrin: A Retrospective 40-Month Study

“…Thus, in the 2 sinus membranes perforated during the surgery, these were repaired with L-PRF clots and behaved exactly the same as the cases without perforations, validating the idea of a natural regeneration and without complications. 2,16 It is important to highlight that this study has a 100% of the implants success, including the cases of sinus membrane perforation, observing no biological complications during 40 months of follow-up. This is similar the results by Dominiak et al, 17 which declared the use of PRF as filling material in maxillary sinus showed promising results.…”

“…Given the fragility of the sinus membrane, its rupture is a common complication during sinus lift and may preclude the use of particulate grafts. 2…”

Tensile Strength Essay Comparing Three Different Platelet-Rich Fibrin Membranes (L-PRF, A-PRF, and A-PRF+): A Mechanical and Structural In Vitro Evaluation

“…An advanced experiment joins the reviews above, managed by Xin and collaborators [ 41 ], which was able to display a total repairment of the perforated Schneiderian membrane and a greater amount of new bone formed under the area through the application of A-PRF in a sinus lift model.…”

Manejo da perfuração de membrana de Schneider em levantamento de seio maxilar com L-PRF: relato de caso

“…As evidências do uso da fibrina rica em plaquetas e leucócitos no reparo das perfurações da membrana sinusal são limitadas. Estudos in vivo em modelo animal tem demonstrado sua efetividade favorável na reparação dessas perfurações comparando com membranas de colágeno e na formação óssea nas áreas enxertadas (Aricioglu, et al, 2017;Xin, et al, 2020).…”