Comparative Radiological Analysis of Efficacy of Beta-tricalcium Phosphate and Beta-tricalcium Phosphate with Platelet-rich Fibrin in Maxillary Sinus Augmentation – A Clinical Study

Context: Bone quantity in the maxillary posterior edentulous area may be insufficient for dental implant placement due to pneumatization of the maxillary sinus. Different solutions were proposed over the years, such as use of short implants, tilted implants placed in the anterior maxilla, zygoma implants, and maxillary sinus floor elevation and grafting procedures with autogenous bone or allografts, xenografts, and alloplastic materials. β-tricalcium phosphate (β-TCP) is known to be excellent promotor of osteoblastic formation and readily resorbed by macrophages and osteoclasts and associated with a lower risk of failure or complications. The use of plateletrich fibrin (PRF) during sinus lift procedures has been advocated for many years during lateral sinus lift or vertical osteotome augmentation. Aim: The aim of the present study was to evaluate the amount of bone formation, clinical and radiological outcomes, and post-operative morbidity of sinus floor elevation procedure performed using β-TCP and β-TCP in combination with PRF. Materials and Methods: Twenty patients who required bilateral sinus lift procedure were accepted into the study and were treated with sinus lift with β-TCP with platelet-rich fibrin (PRF) on one side (Group A) and with only β-TCP on the other side (Group B). The bone height of the ridges was measured on computed tomography (CT) scans (Dentascans) of 0.6 mm sections. Vertical bone heights of all the patients were measured preoperatively and postoperatively on CT scans and the amount of vertical bone gain was assessed. Results: The mean bone height of all the patients who were treated with a direct sinus lift (preoperatively) was 6.0 mm in Group A and 5.8 mm in Group B and the heights varied anywhere between 3.5 mm and 7.4 mm for a total of 50 implant sites. The mean bone gain in direct sinus lift was 5.91 mm on the side of β-TCP with PRF and 5.01 mm on the side of β-TCP. Bone density between the two groups showed statistically significant difference at the 6th month recall when measured by independent t-test. Conclusion: The study indicated that β-TCP with PRF and β-TCP is both effective bone substitutes for sinus floor elevation in oral and maxillofacial region. The mean bone gain in direct sinus lift on β-TCP is comparatively less than β-TCP with PRF.