Comparison of Autologous Blood, Advanced Platelet-Rich Fibrin, and Graftless Approach on New Bone Formation in Sinus...

To evaluate the histologic and radiologic effects of autologous blood (AB), advanced platelet-rich fibrin (A-PRF), and a graftless approach in sinus floor elevation supported by a resorbable membrane and ultrasonic-activated pin system.

A total of 21 sinus floor elevation procedures were performed in 11 New Zealand rabbits that were divided into three groups. Each group planned to include seven maxillary sinus regions. Resorbable membranes and ultrasonic-activated pins (SonicWeld Rx, KLS Martin) were used to support the elevated sinus floor in all groups. After elevation of the sinus floor, bone defects were supported with either AB (Group 1), A-PRF (Group 2), or no biomaterial (control; Group 3). The rabbits were sacrificed 8 weeks after surgery. Specimens were obtained from the upper and lower regions of the sinuses. Radiologic and histologic examinations were performed on all samples. The radiologic examination evaluated new bone formation based on density difference (grayscale [GS]) in axial, coronal, and sagittal planes of CBCT sections. Histologic evaluation was performed by analyzing new bone tissue percentage/score, inflammation, and fibrous tissue parameters.

In the radiologic evaluation, the differences in GS values obtained in Group 3 in all planes were significantly lower than in Group 1 and Group 2, indicating significantly higher bone formation in the control group (P < .05). In the histologic evaluation, the percentage and score of newly formed bone were higher for Group 3; however, that difference was only significant between Group 3 and Group 1 for the specimens taken from the upper regions (P = .005 and P = .018, respectively). Fibrous tissue formation was lower in Group 3; the difference was significant between Group 3 and Group 1 for the specimens taken from the upper regions (P = .037). Inflammation values were similar between the groups.

New bone formation after graftless sinus floor elevation was associated with more successful outcomes than the groups using AB or A-PRF in terms of histologic and radiologic parameters.