Guided Bone Regeneration in the Edentulous Atrophic Maxilla Using Deproteinized Bovine Bone Mineral (DBBM) Combined with Platelet-Rich Fibrin (PRF)—A Prospective Study

Background: Bone regeneration procedures represent a major challenge in oral surgery. This study aimed to evaluate a composite PRF/particulate xenograft in guided bone regeneration. Methods: Edentulous patients with horizontal ridge deficiencies in the anterior maxilla and candidates to an immediate-loading full-arch rehabilitation were included. Horizontal linear measurements indicating bone gain were assessed from computer beam computer tomography (CBCT) scans obtained at pre-surgery, post-surgery, and the 12-month follow-up. Mean bone values were presented as mean ± 95% CI. Non-parametric tests were used as appropriate, and the effect size was calculated with Cohen’s d repeated measures. Results: Eighteen patients were rehabilitated with 72 implants. The mean horizontal bone width was 4.47 [4.13–4.80] mm pre-surgically, 9.25 [8.76–9.75] mm post-surgically, and 7.71 [7.28–8.14] mm 12 months after. Conclusions: PRF associated with a xenograft seems to promote an effective horizontal bone gain. Randomized clinical trials are needed to confirm the benefits of this surgical approach.

[1]  João Caramês,et al.  Implant Survival in Immediately Loaded Full-Arch Rehabilitations Following an Anatomical Classification System—A Retrospective Study in 1200 Edentulous Jaws , 2021, Journal of clinical medicine.

[2]  Feng Wang,et al.  Clinical Outcomes of Immediate Implant Loading with Fixed Prostheses in Edentulous Maxillae: A Systematic Review. , 2021, The International journal of oral & maxillofacial implants.

[3]  J. C. Joly,et al.  Guided bone regeneration in staged vertical and horizontal bone augmentation using platelet-rich fibrin associated with bone grafts: a retrospective clinical study , 2020, International Journal of Implant Dentistry.

[4]  L. Cordaro,et al.  Influence of Bone Anatomy on Implant Placement Procedures in Edentulous Arches of Elderly Individuals: A Cross-Sectional Study on Computed Tomography Images. , 2020, The International journal of oral & maxillofacial implants.

[5]  A. Antonelli,et al.  Evaluation of local hemostatic efficacy after dental extractions in patients taking antiplatelet drugs: a randomized clinical trial , 2020, Clinical Oral Investigations.

[6]  R. Miron,et al.  Improved growth factor delivery and cellular activity using concentrated platelet-rich fibrin (C-PRF) when compared with traditional injectable (i-PRF) protocols , 2020, Clinical Oral Investigations.

[7]  S. Schou,et al.  Histology of augmented autogenous bone covered by a platelet-rich fibrin membrane or deproteinized bovine bone mineral and a collagen membrane: A pilot randomized controlled trial. , 2020, Clinical oral implants research.

[8]  A. Antonelli,et al.  Primary Stability of Three Different Osteotomy Techniques in Medullary Bone: An in Vitro Study , 2020, Dentistry journal.

[9]  H. De Bruyn,et al.  Biomaterials and regenerative technologies used in bone regeneration in the craniomaxillofacial region: Consensus report of group 2 of the 15th European Workshop on Periodontology on Bone Regeneration. , 2019, Journal of clinical periodontology.

[10]  V. Pereira-Filho,et al.  Horizontal ridge augmentation using xenogenous bone graft—systematic review , 2019, Oral and Maxillofacial Surgery.

[11]  L. Chambrone,et al.  Effects of leukocyte-platelet-rich fibrin (L-PRF) in different intraoral bone grafting procedures: a systematic review. , 2019, International journal of oral and maxillofacial surgery.

[12]  A. Giudice,et al.  Management of Facial Pyoderma Gangrenosum Using Platelet-Rich Fibrin: A Technical Report. , 2018, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[13]  M. Chiapasco,et al.  Horizontal bone‐augmentation procedures in implant dentistry: prosthetically guided regeneration , 2018, Periodontology 2000.

[14]  F. Hernández-Alfaro,et al.  The Fate of Lateral Ridge Augmentation: A Systematic Review and Meta-Analysis. , 2018, The International journal of oral & maxillofacial implants.

[15]  M. Quirynen,et al.  Leucocyte‐ and platelet‐rich fibrin block for bone augmentation procedure: A proof‐of‐concept study , 2018, Journal of clinical periodontology.

[16]  M. Quirynen,et al.  The impact of the centrifuge characteristics and centrifugation protocols on the cells, growth factors, and fibrin architecture of a leukocyte- and platelet-rich fibrin (L-PRF) clot and membrane , 2018, Platelets.

[17]  Hom-lay Wang,et al.  The Effect of Implant-Induced Artifacts on Interpreting Adjacent Bone Structures on Cone-Beam Computed Tomography Scans , 2017, Implant dentistry.

[18]  W. Zechner,et al.  Guided Bone Regeneration with Collagen Membranes and Particulate Graft Materials: A Systematic Review and Meta-Analysis. , 2017, The International journal of oral & maxillofacial implants.

[19]  D. Morton,et al.  The Lip-Tooth-Ridge Classification: A Guidepost for Edentulous Maxillary Arches. Diagnosis, Risk Assessment, and Implant Treatment Indications. , 2017, The International journal of periodontics & restorative dentistry.

[20]  K. Freier,et al.  Reconstruction of the severely atrophic edentulous maxillae with calvarial bone grafts , 2017, Clinical oral implants research.

[21]  S. Ghanaati,et al.  Use of platelet-rich fibrin in regenerative dentistry: a systematic review , 2017, Clinical Oral Investigations.

[22]  I. A. Sartori,et al.  Changes in Lip Profile of Edentulous Patients After Placement of Maxillary Implant-Supported Fixed Prosthesis: Is a Wax Try-in a Reliable Diagnostic Tool? , 2017, The International journal of oral & maxillofacial implants.

[23]  R. Miron,et al.  Platelet-Rich Fibrin and Soft Tissue Wound Healing: A Systematic Review. , 2016, Tissue engineering. Part B, Reviews.

[24]  W. Teughels,et al.  The use of leucocyte and platelet-rich fibrin in socket management and ridge preservation: a split-mouth, randomized, controlled clinical trial. , 2016, Journal of clinical periodontology.

[25]  João Caramês,et al.  Ceramic-Veneered Zirconia Frameworks in Full-Arch Implant Rehabilitations: A 6-Month to 5-Year Retrospective Cohort Study. , 2016, The International journal of oral & maxillofacial implants.

[26]  L. Cooper,et al.  Maxillary Implant-Supported Fixed Prosthesis: A Survey of Reviews and Key Variables for Treatment Planning. , 2016, The International journal of oral & maxillofacial implants.

[27]  V. Iacono,et al.  Bone Augmentation of the Edentulous Maxilla for Implant Placement: A Systematic Review. , 2016, The International journal of oral & maxillofacial implants.

[28]  M. Sanz,et al.  Effectiveness of Lateral Bone Augmentation on the Alveolar Crest Dimension , 2015, Journal of dental research.

[29]  Hom-lay Wang,et al.  Alveolar ridge split on horizontal bone augmentation: a systematic review. , 2015, The International journal of oral & maxillofacial implants.

[30]  Sophia P Pilipchuk,et al.  Tissue engineering for bone regeneration and osseointegration in the oral cavity. , 2015, Dental materials : official publication of the Academy of Dental Materials.

[31]  G. Benic,et al.  Horizontal bone augmentation by means of guided bone regeneration. , 2014, Periodontology 2000.

[32]  S. Benedicenti,et al.  Block allograft technique versus standard guided bone regeneration: a randomized clinical trial. , 2014, Clinical implant dentistry and related research.

[33]  C. Galli,et al.  Correlation between Density and Resorption of Fresh-Frozen and Autogenous Bone Grafts , 2014, BioMed research international.

[34]  I. Milinkovic,et al.  Are there specific indications for the different alveolar bone augmentation procedures for implant placement? A systematic review. , 2014, International journal of oral and maxillofacial surgery.

[35]  T. Albrektsson,et al.  A randomized and controlled clinical trial of two different compositions of deproteinized bovine bone and autogenous bone used for lateral ridge augmentation. , 2014, Clinical oral implants research.

[36]  R. Haas,et al.  Patients' preferences towards minimally invasive treatment alternatives for implant rehabilitation of edentulous jaws. , 2014, European journal of oral implantology.

[37]  U. Kuchler,et al.  Horizontal ridge augmentation in conjunction with or prior to implant placement in the anterior maxilla: a systematic review. , 2014, The International journal of oral & maxillofacial implants.

[38]  R. Jung,et al.  Long-term outcome of implants placed with guided bone regeneration (GBR) using resorbable and non-resorbable membranes after 12-14 years. , 2013, Clinical oral implants research.

[39]  E. Tinoco,et al.  Tomographic evaluation of iliac crest bone grafting and the use of immediate temporary implants to the atrophic maxilla. , 2013, International journal of oral and maxillofacial surgery.

[40]  M. Wong,et al.  A systematic review of post-extractional alveolar hard and soft tissue dimensional changes in humans. , 2012, Clinical oral implants research.

[41]  A. Bidra.  Three-dimensional esthetic analysis in treatment planning for implant-supported fixed prosthesis in the edentulous maxilla: review of the esthetics literature. , 2011, Journal of esthetic and restorative dentistry : official publication of the American Academy of Esthetic Dentistry ... [et al.].

[42]  J. Albandar,et al.  Bone regeneration around implants in periodontally compromised patients: a randomized clinical trial of the effect of immediate implant with immediate loading. , 2010, Journal of periodontology.

[43]  T. Albrektsson,et al.  Histological and histomorphometrical analyses of biopsies harvested 11 years after maxillary sinus floor augmentation with deproteinized bovine and autogenous bone. , 2010, Clinical oral implants research.

[44]  D. E. Slot,et al.  Alveolar bone dimensional changes of post-extraction sockets in humans: a systematic review. , 2009, Journal of clinical periodontology.

[45]  Paul Coulthard,et al.  The efficacy of horizontal and vertical bone augmentation procedures for dental implants - a Cochrane systematic review. , 2009, European journal of oral implantology.

[46]  H. Hirayama,et al.  The influence of full-arch implant-retained fixed dental prostheses on upper lip support and lower facial esthetics: preliminary clinical observations. , 2007, The European journal of esthetic dentistry : official journal of the European Academy of Esthetic Dentistry.

[47]  A. Dohan,et al.  Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part I: technological concepts and evolution. , 2006, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[48]  D. Sutton,et al.  Changes in facial form relative to progressive atrophy of the edentulous jaws. , 2004, International journal of oral and maxillofacial surgery.

[49]  Niklaus P Lang,et al.  Critical review of immediate implant loading. , 2003, Clinical oral implants research.

[50]  S. Nyman,et al.  Healing of Bone Defects by Guided Tissue Regeneration , 1988, Plastic and reconstructive surgery.