Immediate loading of the grafted maxillary sinus using platelet rich plasma and autogenous bone: a preliminary study with histologic and histomorphometric analysis.
OBJECTIVE
The goal of this clinical study was to evaluate dental implant survival rates using the concept of a nonfunctional, immediate loading protocol with nonsplinted dental implants in the grafted maxillary sinus during a 52-week period. Random histomorphological and histomorphometric analysis was completed to evaluate the early healing effect of platelet rich plasma (PRP) and 50% autogenous bone combined with 3 different substitute graft materials.


METHODS
Four to 8 months after grafting the sinus with PRP sprayed autogenous bone combined with 3 different substitute graft materials in a 50:50 composite ratio, 27 hydroxyapatite- coated dental implants were surgically placed in 41 patients and immediately loaded between 48 hours and 5 days later with custom titanium abutments and acrylic provisional restorations placed out of functional occlusion. Six months later, definitive ceramometal restorations were cemented on to the custom abutments.


RESULTS
During a 52-week observation period, no implants were lost. Between 4 and 8 months of graft healing time, histologic and histomorphometric analysis revealed formation of new vital bone in different graft specimens ranging from 77% to 100%.


CONCLUSIONS
The preliminary results of this clinical study indicate that immediate nonfunctional loading using PRP and 50% autogenous bone combined with different substitute graft materials is a predictable protocol in the grafted maxillary sinus as early as 4 months of postgrafting. The high implant survival rate is due to the early formation of large percentages of new vital bone as confirmed by using histologic and histomorphometric analysis.
Lee
Cameron Y S
CY
CLee555294@aol.com
Rohrer
Michael D
MD
Prasad
Hari S
HS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001861:Bone Regeneration; D018786:Bone Substitutes; D016025:Bone Transplantation / Q000379:methods*; D003758:Dental Implantation, Endosseous; D015921:Dental Implants; D019094:Dental Prosthesis, Implant-Supported; D019232:Dental Restoration Failure; D003794:Dental Restoration, Temporary; D003799:Dental Stress Analysis; D003831:Denture, Partial, Immediate; D005260:Female; D006801:Humans; D008297:Male; D008443:Maxillary Sinus / Q000601:surgery*; D008875:Middle Aged; D013516:Oral Surgical Procedures, Preprosthetic; D053657:Platelet-Rich Plasma; D013997:Time Factors; D016896:Treatment Outcome
D018786:Bone Substitutes; D015921:Dental Implants