title: Platelet Rich Fibrin (P.R.F.) in reconstructive surgery of atrophied maxillary bones: clinical and histological evaluations.
abstract: BACKGROUND
  Maxillary bone losses often require additional regenerative procedures: as a supplement to the procedures of tissue regeneration, a platelet concentrate called PRF (Platelet Rich Fibrin) was tested for the first time in France by Dr. Choukroun. Aim of the present study is to investigate, clinically and histologically, the potential use of PRF, associated with deproteinized bovine bone (Bio-Oss), as grafting materials in pre-implantology sinus grafting of severe maxillary atrophy, in comparison with a control group, in which only deproteinized bovine bone (Bio-Oss) was used as reconstructive material.
  
  
  METHODS
  60 patients were recruited using the cluster-sampling method; inclusion criteria were maxillary atrophy with residual ridge < 5mm. The major atrophies in selected patients involved sinus-lift, with a second-look reopening for the implant insertion phase. The used grafting materials were: a) Bio-Oss and b) amorphous and membranous PRF together with Bio-Oss. We performed all operations by means of piezosurgery in order to reduce trauma and to optimize the design of the operculum on the cortical bone. The reopening of the surgical area was scheduled at 3 different times.
  
  
  RESULTS
  72 sinus lifts were performed with subsequent implants insertions.We want to underline how the histological results proved that the samples collected after 106 days (Early protocol) with the adding of PRF were constituted by lamellar bone tissue with an interposed stroma that appeared relaxed and richly vascularized.
  
  
  CONCLUSIONS
  The use of PRF and piezosurgery reduced the healing time, compared to the 150 days described in literature, favoring optimal bone regeneration. At 106 days, it is already possible to achieve good primary stability of endosseous implants, though lacking of functional loading.
authors.affiliation: Dept. of Basic Medical Science, University of Bari, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Tatullo
authors.forename: Massimo
authors.initials: M
authors.lastname: Marrelli
authors.forename: Michele
authors.initials: M
authors.lastname: Cassetta
authors.forename: Andrea
authors.initials: A
authors.lastname: Pacifici
authors.forename: Luigi Vito
authors.initials: LV
authors.lastname: Stefanelli
authors.forename: Salvatore
authors.initials: S
authors.lastname: Scacco
authors.forename: Gianna
authors.initials: G
authors.lastname: Dipalma
authors.forename: Luciano
authors.initials: L
authors.lastname: Pacifici
authors.forename: Francesco
authors.initials: F
authors.lastname: Inchingolo
mesh_terms: D000328:Adult; D000818:Animals; D001284:Atrophy; D001861:Bone Regeneration; D002417:Cattle; D003758:Dental Implantation, Endosseous; D005260:Female; D005337:Fibrin / Q000737:chemistry / Q000494:pharmacology; D005602:France; D006801:Humans; D008297:Male; D063175:Mandibular Reconstruction; D008437:Maxilla / Q000254:growth & development / Q000601:surgery; D008443:Maxillary Sinus / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D008903:Minerals / Q000627:therapeutic use; D059745:Piezosurgery; D053657:Platelet-Rich Plasma / Q000737:chemistry
chemical_list: C077540:Bio-Oss; D008903:Minerals; D005337:Fibrin