Effect of Autogenous Blood and Advanced Platelet-rich Fibrin on New Bone Formation in Supported Sinus Floor Elevation by Resorbable Membrane and Ultrasonic-activated Pin System: A Controlled Experimental Study.

Abstract

Purpose: It is well known that the success of dental implants is directly related to bone quantity and quality. This experimental animal study aimed to evaluate the histological and radiological effects of autogenous blood (AB), advanced platelet-rich fibrin (A-PRF) and non-grafted following supported sinus floor elevation by resorbable membrane and ultrasonic-activated pin system.

Materials and methods: Twenty one sinus floor lifting procedures were performed in eleven New Zealand rabbits that were divided into three groups. Each group planned to include seven maxillary sinus regions. Resorbable membrane and ultrasonic-activated pins (SonicWeld Rx®, KLS Martin) were used to support the elevated sinus floor in all groups. After the elevation of the sinus floor, bone defects were supported with autogenous blood (Group 1), with A-PRF in (Group 2) and without using any material in the control group (Group 3). The rabbits were sacrificed at 8 weeks after surgery. Specimens obtained from the upper and lower regions. Radiographic and histologic examinations were performed on all samples. The radiologic examination was performed on new bone formation based on density difference (Grayscale/GS) in axial, coronal and sagittal planes on CBCT sections. Histologic evaluation was performed by analyzing new bone tissue percentage/score, inflammation and fibrous tissue parameters.

Results: In radiologic evaluation, the differences in GS values obtained in Group 3 in all planes were significantly lower than in Group 1 and Group 2, indicating significantly higher bone formation (p<0.05). In histologic evaluation, the percentage and score of newly formed bone were higher for Group 3; however, that difference was significant between Group 3 and Group 1 for the specimens taken from the upper regions (p=0.005 and p=0.018, respectively). Fibrous tissue formation was lower in Group 3; the difference was significant between Group 3 and Group 1 for the specimens taken from the upper regions (p=0.037). Inflammation values were similar between the groups.

Conclusions: New bone formation after sinus floor elevation without using graft material has been associated with more successful outcomes than the group using AB and A-PRF in terms of histological and radiographical parameters.