A qualitative and quantitative assessment of bone regeneration after sinus augmentation. A randomized comparative study

Aim Bone augmentation in the atrophic maxilla is a prerequisite for successful implant rehabilitation. The aim of this study is to evaluate regeneration of bone and to compare the efficacy of PRF in bone regeneration following sinus augmentation surgery in the edentulous posterior maxilla. 

Materials and methods A prospective randomized comparative study was conducted at our institution. The study was allocated into 3 groups: Group I, Platelet Rich Fibrin (PRF) as a stand-alone agent; Group II, Autogenous bone graft; Group III, Alloplastic bone graft (Tricalcium phosphate putty). Groups II and III received PRF as an adjuvant. 

Results On comparing the post-operative bone height and radiodensity of the augmented region, there was statistical significance in Groups II and III. A 6 month post operative CBCT reveals a better bone regeneration in Group III (Alloplastic bone graft - β-Tricalcium phosphate putty). 

Conclusions The results of this study suggest that both autogenous and alloplastic bone grafts are viable graft materials for maxillary sinus augmentation. Platelet rich fibrin, when used as an adjuvant to either alloplastic or autogenous graft enhances bone formation by delivering growth factors at the site of regeneration. However, as a stand-alone agent it failed to provide radiographic evidence of bone formation. The posterior maxilla has always been the most challenging site for implant rehabilitation. There have been various studies, comparing different grafts for successful bone regeneration and stability after implant rehabilitation. Our study aims to search for an ideal grafting material in the maxillary sinus region.