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PRF-Modified Graft Materials in Lateral Sinus Augmentation: A Systematic Review of Histologic Outcome
Guy Kukis1, Gabriele Birbalaite1, Audra Janovskiene2
1Faculty of Odontology, Medical Academy, Lithuanian University of Health Sciences, Eiveniu 2, LT-50161 Kaunas, Lithuania.
Biomedicines
|July 28, 2026
Summary
Platelet-rich fibrin (PRF) enhances bone regeneration in sinus augmentation by increasing new bone and reducing graft material. While PRF aids early healing, its effect on final bone height requires further study.
Area of Science:
- Oral and Maxillofacial Surgery
- Regenerative Medicine
- Biomaterials Science
Background:
- Platelet-rich fibrin (PRF) is explored for maxillary sinus augmentation to boost bone regeneration.
- The histological impact of PRF combined with allografts or xenografts in lateral sinus augmentation needs clarification.
Purpose of the Study:
- To systematically review and evaluate histomorphometric outcomes of PRF-modified grafts versus grafts alone in lateral maxillary sinus augmentation.
Main Methods:
- Systematic review following PRISMA 2020 guidelines, registered in PROSPERO.
- Searched PubMed, Cochrane Library, and Google Scholar for studies within the last 10 years.
- Included RCTs and split-mouth studies assessing histological and histomorphometric outcomes; conducted random-effects meta-analysis.
Main Results:
- Four studies included; PRF groups showed higher percentages of newly formed bone and less residual graft material.
- Meta-analysis revealed a significant increase in newly formed bone (Hedges' g = 0.61, p=0.01) with PRF.
- Significant reduction in residual graft material (Hedges' g = -0.65, p=0.01) observed with PRF; no significant difference in bone height.
Conclusions:
- Adjunctive PRF in lateral maxillary sinus augmentation promotes early bone regeneration and graft remodeling.
- PRF increases new bone formation and decreases residual graft particles but does not significantly alter radiographic bone height.
- PRF is a promising adjunct, not a substitute for grafting materials; further trials are needed for long-term efficacy.
