The use of cortical particulate allograft mixed with plasma-rich fibrin in severe maxillary alveolar ridge atrophy

Abstract

Atrophy in the edentulous maxilla typically consists of vertical bone loss in the posterior maxilla due to pneumatization of the maxillary floor and transverse reduction in anterior areas. The purpose of this study was to perform bilateral sinus floor augmentation and maxillary alveolar bone reconstruction by autologous platelet-rich fibrin (PRF) mixed with mineralized cancellous bone allograft and PRF membranes. Method: Six patients (3 men and 3 women, age 46-65 years) with severe maxillary atrophy were selected for this study. The patient's blood was centrifuged to obtain PRF. Mineralized cancellous bone allograft (Zimmer Puros (R)) was mixed with PRF and applied for sinus floor augmentation in posterior and lateral augmentation in anterior maxillary atrophy. Additionally, PRF membranes were placed over augmented area. Evaluation was carried out before and six months after surgery using CBCT to measure alveolar site dimension. Histology was obtained from corebiopsies taken for implant insertion to evaluate quality of bone regeneration. Results: The use of PRF as cover membrane permitted rapid tissue reparation, high bone quality was detected in sites augmented with bone allograft and PRF. The horizontal alveolar bone volume after 6 months and the vertical bone augmentation increased at about 10 mm. Conclusion: Based on the preliminary case series, the combination of PRF membrane and PRF mixed with bone allograft represents a predictable method of augmenting the sinus floor as well as the deficient anterior maxilla to achieve rehabilitation of the atrophic maxilla with dental implants.

Atrophy in the edentulous maxilla typically consists of vertical bone loss in the posterior maxilla due to pneumatization of the maxillary floor and transverse reduction in anterior areas. The purpose of this study was to perform bilateral sinus floor augmentation and maxillary alveolar bone reconstruction by autologous platelet-rich fibrin (PRF) mixed with mineralized cancellous bone allograft and PRF membranes. Method: Six patients (3 men and 3 women, age 46-65 years) with severe maxillary atrophy were selected for this study. The patient's blood was centrifuged to obtain PRF. Mineralized cancellous bone allograft (Zimmer Puros (R)) was mixed with PRF and applied for sinus floor augmentation in posterior and lateral augmentation in anterior maxillary atrophy. Additionally, PRF membranes were placed over augmented area. Evaluation was carried out before and six months after surgery using CBCT to measure alveolar site dimension. Histology was obtained from corebiopsies taken for implant insertion to evaluate quality of bone regeneration. Results: The use of PRF as cover membrane permitted rapid tissue reparation, high bone quality was detected in sites augmented with bone allograft and PRF. The horizontal alveolar bone volume after 6 months and the vertical bone augmentation increased at about 10 mm. Conclusion: Based on the preliminary case series, the combination of PRF membrane and PRF mixed with bone allograft represents a predictable method of augmenting the sinus floor as well as the deficient anterior maxilla to achieve rehabilitation of the atrophic maxilla with dental implants.