title: Biomechanical Stability of Dental Implants in Augmented Maxillary Sites: Results of a Randomized Clinical Study with Four Different Biomaterials and PRF and a Biological View on Guided Bone Regeneration.
abstract: BACKGROUND
  Bone regenerates mainly by periosteal and endosteal humoral and cellular activity, which is given only little concern in surgical techniques and choice of bone grafts for guided bone regeneration. This study investigates on a clinical level the biomechanical stability of augmented sites in maxillary bone when a new class of moldable, self-hardening calcium-phosphate biomaterials (SHB) is used with and without the addition of Platelet Rich Fibrin (aPRF) in the Piezotome-enhanced subperiosteal tunnel-technique (PeSPTT).
  
  
  METHODS
  82 patients with horizontal atrophy of anterior maxillary crest were treated with PeSPTT and randomly assigned biphasic (60% HA/40% bTCP) or monophasic (100% bTCP) SHB without or with addition of aPRF. 109 implants were inserted into the augmented sites after 8.3 months and the insertion-torque-value (ITV) measured as clinical expression of the (bio)mechanical stability of the augmented bone and compared to ITVs of a prior study in sinus lifting.
  
  
  RESULTS
  Significant better results of (bio)mechanical stability almost by two-fold, expressed by higher ITVs compared to native bone, were achieved with the used biomaterials and more constant results with the addition of aPRF.
  
  
  CONCLUSIONS
  The use of SHB alone or combined with aPRF seems to be favourable to achieve a superior (bio)mechanical stable restored alveolar bone.
authors.affiliation: Institute for Maxillofacial Surgery and Dentistry, General Hospital of Vienna "Hietzing", Wolkersbergenstraße 1, Pavillon 3a, 1130 Vienna, Austria.
authors.forename: Troedhan
authors.initials: T
authors.lastname: Angelo
authors.affiliation: Implantology Clinic Kaiserswerth, Kaiserswerther Markt 25, 40489 Dusseldorf, Germany.
authors.forename: Wainwright
authors.initials: W
authors.lastname: Marcel
authors.affiliation: Implantology Clinic Oberkassel, Dominikanerstrasse 10, 40545 Dusseldorf, Germany.
authors.forename: Kurrek
authors.initials: K
authors.lastname: Andreas
authors.affiliation: Center for Facial Esthetics Vienna, Brauhausgasse 12, 1050 Vienna, Austria.
authors.forename: Schlichting
authors.initials: S
authors.lastname: Izabela
mesh_terms: D000328:Adult; D000368:Aged; D001861:Bone Regeneration; D015921:Dental Implants; D005260:Female; D006801:Humans; D008297:Male; D008437:Maxilla / Q000378:metabolism* / Q000473:pathology; D008875:Middle Aged
chemical_list: D015921:Dental Implants