Dental Implants and Plasma Rich in Fibrine: A Wide Literary Review

Author(s):  
Carlos Fernando Almeida da Silva ◽  
Tayná Toder Santos ◽  
Idiberto José Zotarelli Filho ◽  
Elias Naim Kassis

Introduction: When a dental element is lost in the posterior region of the maxilla, there is natural reabsorption of the alveolar process and at the same time there will be pneumatization of the maxillary sinus. It will increase its volume towards the place where the roots existed and this will often make it difficult or impossible to restore implants in place. For this reason, the procedure for elevating the floor of the maxillary sinus or short implants should be performed when possible. In this context, allogeneic, xenogenous, and alloplastic bone grafts are an alternative for the treatment of bone defects in the jaws, since they avoid the need for a second surgical access. However, due to the need for processing to eliminate antigenic components, these grafts are only osteoconductive with a lower bone formation potential compared to autogenous bone grafts. Also, in this context, in the last 20 years, platelet concentrates have been proposed as regenerative materials in tissue regeneration procedures. Among the platelet concentrates proposed in the literature, PRP and FRP are found to act as autogenous platelet aggregates with osteoinductive properties. Objective: The present study aimed to conduct a wide literature review on maxillary sinus surgery using fibrin-rich plasma. Methods: Experimental and clinical studies (case reports, retrospective, prospective and randomized) with qualitative and/or quantitative analysis were included. Results: The total of 48 articles were found involving Maxillary sinus surgery, Fibrin-rich plasma, and Biomaterials, of which 22 were selected to compose the present study. Conclusion: Based on the literary findings, it was shown that the FRP is favorable for bone formation processes for dental implants, especially when combined with xenografts.

2021 ◽  
Vol 2 (5) ◽  
Author(s):  
Edmilson da Silva Esteves ◽  
Elias Naim Kassis ◽  
Sandey Bernardes da Silva Carvalho

Introduction: In the scenario of maxillary sinus surgery for the later practice of implantology, several surgical techniques can be used to reconstruct the atrophic alveolar ridge, isolated techniques or associated with autogenous, allogeneic, xenogenous, and alloplastic biomaterials. The autogenous bone graft is the only one capable of presenting three important biological properties (osteogenesis, osteoinduction, and osteoconduction) guaranteeing a self-regenerative potential. Platelet concentrates have been proposed as regenerative materials in tissue regeneration procedures. Among the platelet concentrates proposed in the literature, there is FRP that act as autogenous platelet aggregates with osteoinductive properties. As an example of xenografts, Bio-Oss® stands out, being a bovine bone biomaterial. The excellent osteoconductive properties of Bio-Oss® lead to predictable and efficient bone regeneration, becoming an integral part of bone structure and volume. Objective: To carry out a brief systematic review of the main considerations for the use of fibrin-rich plasma and Bio Oss® in bone regeneration for implant dentistry. Methods: The survey was conducted from May 2021 to July 2021 and developed based on Scopus, PubMed, Science Direct, Scielo, and Google Scholar, following the rules of Systematic Review-PRISMA. Study quality was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results: The lack of bone in the alveolar crests has been a major problem in functional aesthetic recovery in patients who have suffered dentoalveolar trauma, traumatic tooth extractions, congenital tooth loss, maxillary and mandibular pathologies, in addition to infections due to the emotional and possibility of deformity. In this context, implant dentistry stands out as a modern method of oral rehabilitation for totally or partially edentulous patients. For this method to develop properly, bone integration of the implant into the recipient bone tissue must occur. It was documented that the combination of biomaterial and FRP significantly improved bone regeneration in the peri-implant area. Placing the implant with the simultaneous use of the FRP creates a good relationship between hard tissue and soft tissue. FRP is used as an adjuvant to Bio-Oss® particles for bone augmentation in the maxillary sinus. Conclusion: Based on literary findings, it was shown that FRP is favorable for bone formation processes for dental implants, especially when combined with Bio-Oss®.


DENS ◽  
2007 ◽  
Vol 15 (2) ◽  
Author(s):  
José Mário Domingos FRAIZ ◽  
Nelson Luis Barbosa REBELLATO ◽  
Delson João da COSTA ◽  
Paulo Roberto MÜLLER ◽  
Ricardo Pasquini FILHO

RECONSTRUÇÃO DE MAXILA ATRÓFICA UTILIZANDO ENXERTO ÓSSEO AUTÓGÊNO DE CRISTA ILÍACA – RELATO DE CASO CLÍNICO Autores: José Mário FRAIZ; Nelson Luis Barbosa REBELLATO; Delson João COSTA; Paulo Roberto MÜLLER; Ricardo PASQUINE. Universidade Federal do ParanáCurso de Pós Graduação em Cirurgia e Traumatologia Buco-Maxilo-Facias Área de Abrangência: Cirurgia e Implantodontia A reabilitação oral de pacientes com maxilas atróficas tem sido bastante discutida na literatura. Esse trabalho apresenta a técnica de reconstrução de maxila atrófica, através de enxertia óssea utilizando osso ilíaco. Uma quantidade mínima de tecido ósseo é necessária para a inserção e manutenção da estabilidade do implante, após a perda dos dentes o processo alveolar maxilar sofre progressiva e irreversível reabsorção, tanto vertical quanto horizontal, podendo atingir um estágio de pneumatização do seio maxilar. Isso contra-indica a instalação de implantes. A literatura sugere que quando há a pneumatização acentuada do seio maxilar e há reabsorção de rebordo alveolar, a técnica de sinus Lift, introduzida primeiramente por TANTUM em 1970, e revisada por MISCH na década de 80, é indicada. Dentre as áreas doadoras, que podem ser crista óssea do ilíaco, calota craniana, costela e tíbia, a crista óssea do ilíaco tem sido uma das opções de escolha por apresentar baixo índice de complicações pós-operatórias, baixa morbidade e menor reabsorção pós-cirúrgica. Esta técnica permite, após seis meses da cirurgia, a instalação de implantes osseointegrados para posterior reabilitação protética. O presente trabalho apresenta um caso clínico de enxertia ósseo de crista ilíaca em maxila atrófica para posterior reabilitação com implantes. Palavras-chave: enxerto ósseo; reabilitação bucal; cirurgia; implantes dentários.Referências Bibliográficas: 1-ABRAHAMS, J. J.; HAYT,M.W.; ROCK, R. Sinus lift procedure of the maxilla in patients with inadequate bone for dental implants: radiographic appearance. Audio journal review-General surgery, Nova York, v. 174, p.1289-1292, 2000.2-AJEN, S. A. Análise por tomografia computadorizada do enxerto autógeno na cirurgia de “sinus lift”. Revista brasileira de radiologia, São Paulo, v. 38, n.1, p.25-31. 2005.3-BEZERRA, F. J. B.; LENHARO, A. Terapia clínica avançada em implantodontia. São Paulo,  Artes Médicas, 2002.4- BREINE, U. & BRÅNEMARK, P.I. Reconstruction of alveolar jaw bone. An experimental and clinical study of immediate and preformed autologous bone grafts in combination with osseointegrated implants. Scandinavian journal of plastic and reconstructive surgery and hand surgery. Supplementum, Stockolmo, p. 14: 23-48, 1980.5- FUGAZZOTTO PA, VLASSIS J. LONG. Term success of sinus augmentation using various surgical approaches and grafting materials. International Journal of Oral and Maxillofacial Implants, Lombard/IL, p.13, 52 -58, 19986- HARBON, S.; CHARTOUNI, M. & RICBOURG, B. Morbidity of iliac bone grafts. A study a propos of 100 consecutive cases. Annales de chirurgie plastique et esthetique, Paris, p. 36, 45- 50, 1991.7-LIM, T. J.; CSILLAG, A.; IRINAKIS, T.; NOKIANI, A.; WIEBE, C.B. Intentional angulation of an implant to avoid a pneumatized maxillary sinus: a case report. Journal of the Canadian dental association, Toronto, v. 70, n.3, p.164-16, 2004.8- MISCH, C.M. RIGDE. Augmentation using mandibular ramus bone grafts for the placement of dental implants: presentation of a technique. Practical periodontics and aesthetic dentistry, Nova York, p. 127-135, 1996.9-NEVES. Jornal Brasileiro de Implantodontia oral. Otimização da estética: uma abordagem dos tecidos mole e duro. Belo Horizonte: Traccio arte e design, 2002.10- RAGHOEBAR GM, BROUWER TJ, REINTSEMA H, VAN OORT, RP. Augmentation of the maxillary sinus floor with autogenous bone for the placement of endosseous implants. Journal of Oral and Maxillofacial Surgery, Filadélfia, p. 51, 1198 -1203, 1993.11- WHEELER SL, HOLMO RE, CALHOUN CJ. Six-year clinical and histologic study of sinus-lift grafts. International Journal of Oral and Maxillofacial Implants, Lombard/IL ,p.-11,26 -34, 1996.  


2018 ◽  
Vol 29 (4) ◽  
pp. 325-334 ◽  
Author(s):  
Julio Leonardo de Oliveira Lima ◽  
Daniel Isaac Sendyk ◽  
Wilson Roberto Sendyk ◽  
Cristiane Ibanhes Polo ◽  
Luciana Correa ◽  
...  

Abstract Several techniques have been proposed for vertical bone regeneration, and many of them use bone autogenous and allogeneic grafts. The purpose of this study was to compare demineralised freeze-dried bone allografts (DFDBA), fresh-frozen (FF) allografts, autogenous bone grafts to find differences between volumetric and histological quantity of bone formation and vertical bone growth dynamic. A vertical tissue regeneration bone model was performed in rabbit calvarias under general anaesthesia. Four hollow cylinders of pure titanium were screwed onto external cortical bone calvarias in eight rabbits. Each one of the cylinders was randomly filled with one intervention: DFDBA, FF, autogenous bone, or left to be filled with blood clot (BC) as control. Allogeneic grafts were obtained from a ninth animal following international standardised protocols for the harvesting, processing, and cryopreservation of allografts. Autogenous graft was obtained from the host femur scraping before adapting hollow cylinders. Animals were euthanized at 13 weeks. Vertical volume was calculated after probe device measurements of the new formed tissue inside the cylinders and after titanium cylinders were removed. Histomorphometry and fluorochrome staining were used to analyse quantity and dynamic of bone formation, respectively. Results showed that DFDBA and fresh-frozen bone improved the velocity and the quantity of bone deposition in distant portions of the basal plane of grafting. Remaining material in allograft groups was more intense than in autogenous group. Both allografts can be indicated as reliable alternatives for volume gain and vertical bone augmentation.


2010 ◽  
Vol 36 (5) ◽  
pp. 333-343 ◽  
Author(s):  
Ivy Kiemle Trindade-Suedam ◽  
Juliana Aparecida Najarro Dearo de Morais ◽  
Rafael Silveira Faeda ◽  
Fábio Renato Manzolli Leite ◽  
Guilherme Monteiro Tosoni ◽  
...  

Abstract The objective of the present study was to evaluate the outcomes of autogenous bone graft (AB) and bioglass (BG) associated or not with leukocyte-poor platelet-rich plasma (LP-PRP) in the rabbit maxillary sinus (MS) by histomorphometric and radiographic analysis. Twenty rabbits divided into 2 groups (G1, G2) were submitted to sinus lift surgery. In G1, 10 MS were grafted with AB and 10 MS were grafted with BG. In G2, 10 MS were grafted with AB + LP-PRP and 10 MS were grafted with BG + LP-PRP. After 90 days, the animals were killed and specimens were obtained, x-rayed, and submitted to histomorphometric, radiographic bone density (RD) and fractal dimension analysis. Radiographic bone density mean values (SD), expressed as aluminum equivalent in mm, of AB, BG, AB + LP-PRP, and BG + LP-PRP groups were 1.79 (0.31), 2.04 (0.39), 1.61 (0.28), and 1.53 (0.30), respectively. Significant differences (P < 0.05) were observed between BG and AB, and BG + PRP and BG. Fractal dimension mean values were 1.48 (0.04), 1.35 (0.08), 1.44 (0.04), and 1.44 (0.06), respectively. Significant differences were observed between BG and AB, and AB + LP-PRP and BG. Mean values for the percentage of bone inside MS were 63.30 (8.60), 52.65 (10.41), 55.25 (7.01), and 51.07 (10.25), respectively. No differences were found. No correlations were observed among percentage of bone, RD and FD. Histological analysis showed that MS treated with AB presented mature and new bone formation. The other groups showed minor bone formation. Within the limitations of this study, the results indicated that at a 90-day time end point, AB yielded better results than AB + LP-PRP, BG, and BG + LP-PRP and should be considered the primary material for MS augmentation.


2015 ◽  
Vol 2015 ◽  
pp. 1-20 ◽  
Author(s):  
Mina W. Morcos ◽  
Hadil Al-Jallad ◽  
Reggie Hamdy

Bone is one of the most dynamic tissues in the human body that can heal following injury without leaving a scar. However, in instances of extensive bone loss, this intrinsic capacity of bone to heal may not be sufficient and external intervention becomes necessary. Several techniques are available to address this problem, including autogenous bone grafts and allografts. However, all these techniques have their own limitations. An alternative method is the technique of distraction osteogenesis, where gradual and controlled distraction of two bony segments after osteotomy leads to induction of new bone formation. Although distraction osteogenesis usually gives satisfactory results, its major limitation is the prolonged duration of time required before the external fixator is removed, which may lead to numerous complications. Numerous methods to accelerate bone formation in the context of distraction osteogenesis have been reported. A viable alternative to autogenous bone grafts for a source of osteogenic cells is mesenchymal stem cells from bone marrow. However, there are certain problems with bone marrow aspirate. Hence, scientists have investigated other sources for mesenchymal stem cells, specifically adipose tissue, which has been shown to be an excellent source of mesenchymal stem cells. In this paper, the potential use of adipose stem cells to stimulate bone formation is discussed.


2014 ◽  
Vol 6 (3) ◽  
pp. 118-120 ◽  
Author(s):  
Santosh Kumar Swain ◽  
Ranjan Kumar Sahoo ◽  
Mahesh Chandra Sahu

ABSTRACT Antrorhinolith is an uncommon nasal mineralized mass of nasal cavity invading into maxillary sinus. Most antrorhinoliths are small and asymptomatic, caused by calcification of a nidus and are detected incidentally on radiological examination. Sometimes they present symptoms like pain and foul smelling nasal discharge. Here, we are presenting two cases of antrorhinoliths. One was found after endoscopic sinus surgery and second one was seen in patient with prolonged use of topiramate medication. In all these two cases, radiological examination revealed a discrete bony density in the nasal cavity and maxillary sinus which was blocking the ostiomeatal complex. The bony mass was removed endoscopically from the nasal cavity and maxillary sinus with drainage of discharge and debris from the sinuses. Histopathological examination revealed an antrolith with bony nidus and calcium deposited around it. How to cite this article Swain SK, Sahoo RK, Sahu MC. Two Case Reports of Antrorhinoliths. Int J Otorhinolaryngol Clin 2014;6(3):118120.


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