Radiographic evaluation of maxillary sinus floor height after direct maxillary sinus augmentation using β-tricalcium phosphate and platelet rich fibrin.

The rehabilitation of patients affected by posterior maxillary atrophy by the aid of implant-supported fixed prosthesis presents a challenge in many cases.  Frequently, the available residual alveolar ridge is insufficient for the placement of dental implants because of alveolar bone resorption, pneumatization of the maxillary sinus, or their combination.

Maxillary sinus floor augmentation is the treatment of choice when insufficient alveolar bone height prevents placement of dental implants in the posterior edentulous maxilla.  Maxillary sinus augmentation was first presented by Tatum in 1976.  Long term results showed that this technique can be an effective treatment option.

Grafting materials used in sinus floor augmentation procedure can be in the form of bone blocks (cancellous or corticocancellous) or bone particles.   Although autogenous bone is considered the gold standard because of its high biocompatibility and osteoinductive potential, its disadvantages include  extra surgical site, donor site morbidity, increased cost and total operation time.

To reduce the problems associated with autografts, many authors have advocated the use of bone substitutes such as demineralized freeze-dried bone allograft(DFDBA), mineralized freeze-dried bone allograft(FDBA), xenografts, hydroxyapatite preparations, calcium sulfate preparations, as well as growth factors embedded in different carrier materials to augment the floor of the maxillary sinus.

Amongst alloplasts, β-tricalcium phosphate (β-TCP) is a biocompatible       alloplast and is of the highest purity. β- TCP has a crystalline structure and its porosity provides optimal biologic properties, i.e., osteoconductivity and total resorbability. It has calcium to phosphate ratio of 1:1.5, with particle size ranging from 0.5 to 1.0 mm and resorbs progressively, releasing calcium and phosphate ions, which promote new bone formation within 3-6 months. It has found its multiple clinical applications in dentistry in the treatment of bone defects, ridge and socket preservations, and periodontal osseous defects including furcation defects.

Platelet rich fibrin (PRF) is an autologous preparation of concentrated platelets created by centrifugation of a patient’s blood.  The use of PRF during surgical procedure is a current treatment concept used to accelerate wound healing and tissue maturation.  It can be used directly as a clot or after compression as a strong membrane.

Aim:

To radiographically evaluate the newly formed bone after direct maxillary sinus floor augmentation using β-TCP and platelet rich fibrin (PRF).

Objectives:

1.     To evaluate distance from alveolar ridge crest to the inferior most point on the sinus floor pre-operatively.

2.    To evaluate distance from alveolar ridge crest to the raised sinus floor post-operatively after 5 months.

3.    To evaluate increase in height of alveolar ridge crest post-operatively after 5 months.

Sample size: 12