Maxillary Sinus Lift Using Autologous Periosteal Micrografts: A New Regenerative Approach and a Case Report of a 3-Year Follow-Up

Abstract

This case report discusses about an innovative bone regeneration method that involves the use of autologous periosteal micrografts, which were used for a maxillary sinus floor lift in a 52-year-old female patient. This method allows for harvesting of a graft that is to be seeded on a PLGA scaffold and involves collection of a very little amount of palatal periosteal tissue in the same surgical site after elevation of a flap and disaggregation of it by using a Rigenera® filter. Histological samples collected at the time of implant installation demonstrate a good degree of bone regeneration. The clinical and radiographic outcomes at the 3-year follow-up visit showed an adequate stability of hard and soft tissues around the implants. This report demonstrates the possibility to obtain a sufficient quality and quantity of bone with a progenitor cell-based micrograft and in turn make the site appropriate for an implant-supported rehabilitation procedure, with stable results over a period of two years.

Micro-Raman Spectroscopy of Dental Implants Subjected to Different Surface Treatments

“…From Brånemark's initial studies, titanium represents the most-used material, although not the only one, for the production of endosseous dental implants [1][2][3]. Success rates with titanium implants are high in both the short and long term; moreover, they are indicated in many particular situations [4][5][6][7][8][9][10].…”

Rigenera® Autologous Micrografts in Oral Regeneration: Clinical, Histological, and Radiographical Evaluations

“…At 12 months, the mean radiographic bone fill levels were 3.9 ± 1.5 mm and 1.6 ± 1.1 mm in the test and control groups, respectively. Regarding sinus lift, in a retrospective study [18], radiological follow-up at 4 months showed greater mineralization in the group treated with a micrograft combined with hydroxyapatite than in the two control groups in which hydroxyapatite or deproteinized bovine bone was used alone. Histological and histomorphometric data showed a statistically significant result, with more vital mineralized tissue (p<0.004) in the group treated with combined micrograft/hydroxyapatite (58.5 ± 2.5% with respect to the control group) than in those treated with hydroxyapatite (20.2 ± 3.1%) or deproteinized bovine bone alone (48 ± 2.5%), and more non-mineralized tissue (p < 0.003) in the group treated with combined micrograft/hydroxyapatite (41.4 ± 5.6%) than in those treated with hydroxyapatite (5.5 ± 1.6%) or deproteinized bovine bone alone (20.5 ± 3.1%).…”

“…In the control group, a collagen sponge or hydroxyapatite alone was used (Table 3). Sinus augmentation with micrografts was described in a retrospective study [16] and in two case reports [17,18], whereas periodontal regeneration was assessed in a randomized clinical trial [19], a case series [20], and a case report [21]. Furthermore, two case series of socket preservation with test and control were published by d 'Aquino et al in 2009 [22] and 2016 [23].…”

“…In the three studies [16][17][18] included for the augmentation of the sinus floor, a simple flap and a lateral bone window were used; after membrane elevation, in two studies, a periosteal sample was collected, whereas in a single study by Brunelli et al [17], the pulp of a third molar extracted for malposition was used. From the tissue samples, micrografts were generated and used as adjuncts to hydroxyapatite (Alos ® , Allmed srl, Lissone, Italy) or collagen sponge (Gingistat, GABA, Rome, Italy) in order to form a regenerative complex.…”

Covalently-Linked Hyaluronan versus Acid Etched Titanium Dental Implants: A Crossover RCT in Humans

“…Even though it was not necessary because randomization was implemented before surgery, the implant label choice for the sides of the mouth was randomized by a coin toss. The surgical protocol of installing the implants was well documented and consisted of a full thickness mucosal flap elevation, the preparation of the implant site, the installation of the implant with the prosthetic platform (that is, the edge of the collar) at the level of the bone crest, the positioning of the surgical cover screw, and the closing of the flap with sutures [73,74,75,76,77,78,79,80]. The surgery was done under coverage of antibiotics (2 g of amoxicillin and clavulanic acid per os one hour before surgery, followed by administration of 1 g after 6 and 18 h).…”