Private Practice, Ra'anana, Israel.
J Periodontol. 2009 Dec;80(12):2056-64. doi: 10.1902/jop.2009.090252.
Sinus augmentation with simultaneous implant placement without bone graft material is a hotly debated technique. This technique could be improved and secured by the use of an autologous leukocyte- and platelet-rich fibrin (PRF) (Choukroun's technique) concentrate. The objectives of this study were to assess the relevance of PRF clots and membranes as the sole filling material during a lateral sinus lift with immediate implantation using radiologic and histologic analyses in a case series.
Twenty-five sinus elevations with simultaneous implantation were performed on 20 patients with Choukroun's PRF as the sole filling biomaterial. For each patient, a presurgical exam and a 6-month post-surgical radiologic exam were performed with a panoramic x-ray and three-dimensional volumetric computed radiography (VCR) to evaluate the subsinus residual bone height and the final bone gain around the implants. In nine patients, 6 months after the sinus lift, bone biopsies were collected on the buccal wall of the alveolar ridge at the level of the osteotomy window, and evaluated by histomorphometry.
In this study, 41 implants from three different systems with different screw designs (Biomet 3I Nanotite, MIS Seven, Intra-Lock Ossean) were placed. All implants were inserted in residual bone height between 1.5 and 6 mm (mean +/- SD: 2.9 +/- 0.9 mm). The final bone gain was always very significant (between 7 and 13 mm [mean +/- SD: 10.1 +/- 0.9 mm]). No implant was lost. After radiologic analyses, the position of the final sinus floor was always in the continuation of the end of the implant. All biopsies showed well organized and vital bone.
From a radiologic and histologic point of view at 6 months after surgery, the use of PRF as the sole filling material during a simultaneous sinus lift and implantation stabilized a high volume of natural regenerated bone in the subsinus cavity up to the tip of the implants. Choukroun's PRF is a simple and inexpensive biomaterial, and its systematic use during a sinus lift seems a relevant option, particularly for the protection of the Schneiderian membrane.
同期植入物放置而不使用骨移植材料的窦腔增大是一项备受争议的技术。这种技术可以通过使用自体白细胞和血小板丰富的纤维蛋白（PRF）（Choukroun 技术）浓缩物来改善和固定。本研究的目的是通过在一系列病例中使用放射学和组织学分析来评估 PRF 凝块和膜作为唯一填充材料在侧窦提升和即刻植入术中的相关性。
20 名患者共进行了 25 例窦腔提升和同期植入术，其中 Choukroun 的 PRF 作为唯一的填充生物材料。对每位患者进行术前检查和术后 6 个月的放射学检查，使用全景 X 线和三维容积计算放射摄影（VCR）评估窦下残留骨高度和植入物周围最终骨增量。在 9 名患者中，在窦提升后 6 个月，在牙槽嵴骨切开窗水平的颊侧壁采集骨活检，并通过组织形态计量学进行评估。
在这项研究中，使用了三种不同系统的 41 个植入物，具有不同的螺杆设计（Biomet 3I Nanotite、MIS Seven、Intra-Lock Ossean）。所有植入物均植入残留骨高度为 1.5 至 6 毫米（平均 +/- 标准差：2.9 +/- 0.9 毫米）。最终骨增量始终非常显著（7 至 13 毫米之间[平均 +/- 标准差：10.1 +/- 0.9 毫米]）。没有植入物丢失。放射学分析后，最终窦底的位置始终在植入物末端的延续处。所有活检均显示组织完整且有活力的骨。
从术后 6 个月的放射学和组织学角度来看，在同期窦提升和植入术中使用 PRF 作为唯一填充材料，可稳定大量自然再生骨在窦腔中，直至植入物尖端。Choukroun 的 PRF 是一种简单且经济实惠的生物材料，在窦提升术中系统使用似乎是一种相关的选择，特别是对于保护 Schneiderian 膜。
