Effects of Choukroun's platelet-rich fibrin on bone regeneration in combination with deproteinized bovine bone mineral in maxillary sinus augmentation: A histological and histomorphometric study

Purpose: The potential effect of Choukroun's platelet-rich fibrin (PRF) in combination with allograft on promoting bone regeneration has been discussed in previous publications. This study aims to evaluate an influence of PRF on bone regeneration in sinus augmentation in combination with a xenograft, deproteinised bovine bone. Materials and methods: Eleven sinuses from 10 patients with posterior maxillary bone atrophy were selected for the study. As a test group, six sinus floor elevations were grafted with a Bio-Oss and PRF mixture, and as control group, five sinuses were treated with Bio-Oss alone. Clinical and radiographic examinations were performed pre- and postoperatively. After 6 months of sinus augmentation, bone biopsies were obtained from the grafted posterior maxilla, and un-decalcified ground sections were prepared. Bone characteristics were evaluated using histological observation and histomorphometric analyses. Results: No adverse effect was observed in any case within the follow-up period of 6 months after sinus augmentation. Histological observation showed similar morphological characteristics for both the PRF and control groups. The percentage of new bone formation in the PRF group was about 1.4 times of that in control (18.35%+/- 5.62% vs. 12.95%+/- 5.33%), while the percentage of residual bone substitute in the control group was about 1.5 times higher as that in the PRF group (28.54%+/- 12.01% vs. 19.16%+/- 6.89%). The percentage of contact length between newly formed bone and bone substitute in the PRF group was 21.45%+/- 14.57% vs. 18.57%+/- 5.39% in the control. No significant statistical differences between the two groups were found in these observed parameters. Conclusions: Our preliminary result demonstrated neither an advantage nor disadvantage of the application of PRF in combination with deproteinised bovine bone mineral in sinus augmentation after a healing period of 6 months. (C) 2011 European Association for Cranio-Maxillo-Facial Surgery.Dentistry, Oral Surgery & MedicineSurgerySCI(E)PubMed14ARTICLE4321-3284