Platelet-Rich Plasma in Maxillary Sinus Augmentation: Systematic Review

Area of Science:

• Oral Surgery
• Regenerative Dentistry
• Biomaterials Science

Background:

• Sinus augmentation procedures can utilize grafting biomaterials or not.
• Limited high-quality evidence exists on using only platelet concentrates for sinus floor augmentation.
• Platelet concentrates may enhance healing and bone regeneration via angiogenesis and bone formation.

Purpose of the Study:

• To evaluate the effect of sole platelet concentrate use in sinus augmentation on new bone formation, augmented height, and clinical outcomes.
• To assess the additional benefits of platelet-rich fibrin (PRF) when combined with other grafting biomaterials.

Main Methods:

• A systematic review adhering to PRISMA guidelines was performed.
• Pooled analyses were conducted using Review Manager software.
• Included studies focused on sinus augmentation with or without PRF.

Main Results:

• Eleven studies on sole platelet concentrate use were qualitatively synthesized; only one clinical trial showed better outcomes with allograft than titanium-PRF (T-PRF).
• Twelve studies using PRF with biomaterials were meta-analyzed, showing no additional benefits in bone height or soft tissue area.
• A significantly lower percentage of residual bone substitute material was observed with PRF, and newly formed bone was slightly, but not significantly, higher.

Conclusions:

• Robust evidence for the sole use of platelet concentrates in sinus augmentation is lacking.
• Studies suggest favorable outcomes for implant survival, bone gain, and height.
• PRF combined with biomaterials offers no significant additional benefits for bone height but may enhance healing and bone formation.
• Well-designed randomized clinical trials (RCTs) are needed to guide clinical practice.